End of the Road or Time to Re-Start?

What is the Future for Health Mutuals in a Post-Covid World?

Craig Dearden-Phillips MBE & Mark Goodchild 

Make no mistake, the coming re-ordering of health and care post C19 is the single biggest strategic challenge for every health and care mutual. The determination of Government to never be caught out again means two things.

Firstly, there will a tightening of grip from Whitehall. Ministers have relished the ability to command the NHS army. Secondly, the NHS will be politically un-touchable with direct implications for independent NHS partners like you.

So the clock is ticking.

But it is counting down not only on the ‘single-contract, single-location’ mutuals but also those that have made steady progress since spinning out, winning plaudits from CQC and regulators. The truth is that this will not be enough to avoid re-colonisation by a resurgent NHS. You now have to get really ambitious about your distinct mission – or accept the inevitable.

What’s on the road ahead?

A number of things seem to be becoming clearer as we move along:

• A sharper focus on how to keep people away from acute settings – pointing to

an enhanced role for primary and community providers.

• The NHS having an even stronger ‘command button’ over local health & care systems.

• A rapid acceleration of ‘vertical integration’ – i.e. placing all provision under a single locus of operational control (probably an NHS acute or community trust).

• The rapid acceleration of digital technology and remote monitoring in primary and community settings.

Possibilities around organic growth:

During the emergency, many of you have experienced a lift in revenue as the NHS and Councils have enlisted you to help to create capacity and treat C19 patients outside hospital. Ongoing this will probably continue with the long tail of C19 running well into 2021.

So you can expect opportunities in the following areas:

• Safeguarding the health of vulnerable groups who might otherwise catch and spread C19 eg. People who are vulnerably housed.

• Relieving pressure on the NHS through your expertise on managing all sorts of patients outside of hospital.

• Helping those at risk of falling gravely ill from Covid19 to becoming all-round healthier.

Possibilities around mergers and acquisitions 

The most successful health mutuals are not squeamish about mergers, acquisitions and joint-ventures. Scale in healthcare will probably matter more in the coming period.

The smallest NHS Trusts are many times the size of most health mutuals. A resurgent, centralising NHS, back under political control, will soon have its tanks on your lawn.

So having a larger footprint than one single health economy can bring credibility, expertise and investment. It hedges your risks. You are less easily dominated. You know the world beyond your local patch and can bring this knowledge into the local healthcare system (many of which are parochial). In short you can add value.

So, think about who you might join forces with as you go forward.

What next for you?

In our view, the successful health mutual of 2025 will have the following seven key attributes:

1. You are Indispensable.

You are now utterly irreplaceable as a skilled, flexible and innovative operator on the interface of health and care – meaning that without you, any healthcare system in which you operate would be significantly more expensive, of lower quality and much higher risk.

2. You are Integrated.

You will be a super-nimble player ensuring the cohesion of the (large, lumbering) NHS acute sector, the primary care sector (small-scale unmanageable) and Councils (diversified, distracted). You will be the oil in this cranky machine.

3. You are ‘Added-Value’.

You will need the Heineken-effect – touching the parts of health nobody else reaches (90% of health outcomes being socially determined). You use the freedom of being a Community Interest Company to do something truly brilliant in each of the communities you serve.

4. You are Bigger.

This is a tough message. Many of you are currently sub-scale. You are easily picked off. Those NHS tanks will soon be on your

lawn. Your job, to put it boldly, is to seek opportunities so that by 2025 it is YOUR tanks on THEIR lawn. You will achieve this by becoming the deeply-capable community provider that the NHS in every area will need.

5. You are Independent.

By 2025, you will have a diversified income and the confidence that comes with it. You will be spread across many local health and care systems, helping them to learn and adapt from each other.

6. You are Innovative.

You will be several steps ahead of other providers locally and your sights are set on influencing nationally. You do not spend any time fretting about the latest commands from ‘on-high’ and you innovate without permission or fear.

7. You Attract Talent.

You are an exemplar employer. Talented people will choose you over the NHS because of the brilliant culture you have created and

the fact that you empower staff rather than tell them how to do their jobs.


What really tough questions should you be asking yourself now?  

What do I want us
to be famous for?

CQC and industry ratings are not the currency of the future.
You need to be known as an organisation which is at the top
of its specialism. Untouchable.


Am I an innovator?

You need to ask if you are doing enough to drive innovation or whether you need a new plan that breaks you out from the status of ‘NHS legacy provider’.

Can I lead growth?

You need to ask if you are doing enough to drive both organic growth but also mergers and acquisitions.

Can I attract and retain the best talent?  

If you can’t become an employer of choice your best option would be to rejoin the NHS. Think about your Talent Strategy.

Can I personally drive impact?

Are you actually doing enough to truly claim that you do enough ‘beyond contract’ to justify not re-entering the NHS?

Act Today. Don’t Delay.Press Re-Start.

At the moment, Social Minds are working with several ambitioushealth mutuals on their own Re-Start journey:If you want to be part of this exciting conversation, get in touch.@deardenphillips | 07764 203 969craig@socialminds.org.uk|www.socialminds.org.uk.