Social Enterprise – the future of Occupational Therapy (Callum’s MSc journey)

Highlight: May 2021: “Social Enterprise – The future of Occupational Therapy” 

(Part of ‘Callum’s MSc journey: Advancing Practice in Occupational Therapy’ series)

Introduction to my ‘MSc journey’ series of blogs…

In my role as Occupational Therapy Lead at bOunceT, I have been studying some modules from the innovative Post-Registration Masters in Occupational Therapy at Queen Margaret University in Edinburgh. I started this course in September 2019, as well as working at bOunceT full time with a small team alongside me

Why would I chose to do this ‘extra’ work on top of starting and running a business???

Well, because the modules available to study looked brilliant and the flexibility of the programme drew me in! The course tutors were very encouraging of me participating on the MSc, even working full-time, as I could effectively ‘choose’ what to study and write about within many of the modules and final research project. Therefore, in theory I could write about my work at bOunceT and ‘link’ this to occupational therapy and occupational science principles – somewhat ‘proving’ what we do ‘really is’ within the remit of occupational therapy. This comes from (mixed) experiences/opinions/comments from colleagues, local healthcare professionals and other stakeholders of my business about my experience of starting my career outside of the NHS ‘so young’ and ‘inexperienced’. I explain more about this within my blog:

  • Too ‘young’ & ‘dumb’? Doing OT differently straight out of Uni.

Other blogs available in my MSc journey series so far include:

  • Translating theory into practice – critically engaging with “occupation”
  • Why do we leave parents out of therapy?
What do I want to tell you about within this blog? 
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Thanks to the incredible learning from this MSc course, and/ or perhaps thanks to my continued experience leading an innovative non-profit business within the state of the world right now (due to COVID-19), I believe now more than ever what we do at bOunceT embraces ‘core occupational therapy’ values and principles. I completed an essay over the Christmas break in lockdown which focused on exploring research methods, but the first half of this essay was about setting the scene for why a particular area of practice needed to be examined. Naturally, I felt the area of social enterprise should be looked into further so I started to ‘google’ and search on literature databases for what research already exists within occupational therapy about this topic.

Shockingly, across the healthcare world and in particular within the profession of occupational therapy, there is very little knowledge about what a social enterprise is, and what the benefits of this business model are.

I thought…surely this was not the case?! Surely this must be wrong, since there is such a big push at Scottish Government and international level for #SocialEnterprise and #BusinessForGood to become the ‘next best thing’ across many sectors, including health and social care!

Therefore, the potential for a social enterprise model to be considered an effective way of delivering occupational therapy was the motivation behind the development of my MSc research…and this blog!

Social Enterprise – ‘Business World’

The consensus internationally is that there is not one single definition of the term ‘social enterprise’. However, it is often described like a private organisation whose profits must be re-invested back into the business to achieve their social and environmental mission, or purpose.   

Although commonly mistaken for one, social enterprises are not charities. However, social enterprises do often deliver elements of charitable support (free or discounted services) as well as offering paid for services. For example, even at bOunceT we offer some fully-funded support (made possible via generous grant funders) whilst balancing this with charging various stakeholders for payment (e.g. parents/carers, social work departments, local council healthcare teams, other organisations and charities).

According to Social Enterprise Scotland & Scottish Government, Scotland is a leading country within the global social enterprise movement. This certainly looks like the case as there is an abundance of research and ‘talk’ online about this type of business model and the benefits of it in practice (at different levels – e.g. at a public health level and its benefits to people and society – compared to the model being used to help companies with their corporate social responsibility – CSR).

According to Social Enterprise UK, the largest proportion of the social enterprise sector is ‘Health and Social Care’. Interestingly, 61% of social enterprises across the UK are delivering services to the public sector… so it is well known across that these services need the support of social enterprises and charities to meet the ever changing needs of society (e.g. Public Health Priorities). Well, isn’t that interesting?! So, the same pot of money which funds our NHS/Councils can actually fund other organisations to support people in need. Therefore there is obviously a need for partnership working across all sectors.

One of the challenges we have faced when offering our service is that it is felt that ours should be a free service, like the NHS. It has been a huge challenge to overcome OT’s and others ‘personal or professional opinions’ as I was a young, newly qualified OT ‘trying to do something good’. I talk more about this within my blog referenced above, but we did have some families tell us that one of their OT’s from another (local) service told them not to come to bOunceT. I have never really explored this further, but my assumption is that it’s all down to understanding ‘what do they do, why, and how’.

I can’t help but think this all stems from the general belief that ‘healthcare should be free’……so of course why would you pay for something I am branding under the heading of ‘occupational therapy’. I naturally support this view 100% – but you could argue that nothing is ever ‘free’. Someone, somewhere has to pay for it … more than likely from income tax and/or donations and grants.

Without going into it too much, I discovered that within nursing and other health professions, the thought of developing a social enterprise model ‘within’ NHS structures has already been discussed for a few decades! There are fantastic examples of public sector services and/or individuals who lead NHS services who have set up a social enterprise (to help with service capacities and/or give more choice to staff and service users). I know this is a bit confusing now, and it does confuse me as I’m not an expert in this field, but more or less it seems pretty ‘well known’ across the business world and healthcare world that a social enterprise model serves a good purpose!

Scotland's Social Enterprise Strategy | British Association for Supported  Employment
Scotland’s Social Enterprise Strategy 2016-26
& read ‘Scotland’s Vision for Social Enterprise 2025’ here!

Social Enterprise – ‘OT World’

In very simple terms, the concept of a ‘social enterprise’ is not typically known across healthcare, especially by occupational therapists. It is true that there are some – although here I stress the emphasis on some – local and international occupational therapists who have embraced a social enterprise model within their practice (me being one of them).

Despite this minimal amount of social enterprise activity within OT, the benefits about how therapists can innovatively deliver their services – combined with the associated benefits for the people they are working with are crystal clear. Stickley and Hall (2017) appear to be the first – and currently the only – researchers to study the value of adopting a social enterprise model in occupational therapy practice. I thought this was one of the BEST reads since qualifying in 2017 and I would HIGHLY recommend it to anyone and everyone in the OT world thinking about ‘new ways of working’.

Interestingly, the Royal College of Occupational Therapists (RCOT) have continuously and actively encouraged OT’s to become pioneers in developing new roles for themselves. This is probably due to the ever changing political and economic factors influencing the healthcare landscape. Although, saying that, the idea that occupational therapy is continually evolving due to developments in research and success in practice typically has been – and currently is – embraced by most.

More recently, I was promoted by the RCOT to advertise and ‘shout out’ about innovative and role-emerging practice as a route to achieving growth and career development opportunities (via #ChooseOT campaign – . This has been one of the most significant ‘non official endorsements’ to date! I have always liaised with RCOT regarding my work to make sure it ‘fits’ within my registration as an OT. Being able to take part in this campaign was a great personal achievement for me as it kind of ‘confirms’ that I have been right to continue with bOunceT even when the going was getting tough during my first year of setting up!

OT’s have long advocated for maximising ‘occupation-focused practice’ aka working with our ‘OT glasses’ on which make us focus on what WE do best, not just what we do ‘generally’ and/or compared to Physio’s for example. The pressure has been put on us as professionals a little bit too as healthcare colleagues like Physio’s are using ‘our’ words now (e.g. function and meaningful activity). Across research and practice, this seems to make OT’s seriously reflect on ‘what do we have that other professionals do not’.

Well, it would appear that expanding our practice by embracing ‘new ways of working in OT’ out with the public sector and the ‘traditional’ medical model of practice is one of the ways forward!

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Me with Aileen Campbell (MSP) at Social Enterprise Awards 2018 in the Scottish Parliament

My success within the Social Enterprise & OT world

Some of the points below are examples of awards I have won, or things I have been able to achieve, due to being an Occupational Therapist leading a social enterprise!

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What’s next for Social Enterprise in Occupational Therapy?

As the world evolves, the need for social enterprises to creatively meet needs across society will only grow stronger as we look to build a more inclusive, fairer and more sustainable world. I believe that a social enterprise model will be at the heart of this (in business and across services in different sectors).

The success I have had within bOunceT to date proves that there are more career paths outside the NHS than many of us traditionally think. It should be used as a ‘showcase’ to students, new graduates, and experienced practitioners as one of many careers paths to take…….although I do have to thank academic staff from Universities across Scotland and England as my journey has been embraced by lecturers and other staff who are pretty forward thinking!

Personally, I would love for bOunceT to reach beneficiaries across all parts of the UK, and potentially one day the world… I know I’m not the only one with these ambitions (as I work away in the background looking at social relocation models to grow!). I believe as we continue to grow, we could continue to diversify what we offer, and how. For example, as we launch our own ‘top trump style’ therapeutic play cards, we could adopt a ‘buy one, give one’ donation model, to expand our social impact bigger than it has ever been before!

Therefore, based on the (growing) research and interest in this field from occupational therapists, in addition to my own personal experience, I believe simply that social enterprise is the future of Occupational Therapy.

THANK YOU AGAIN for reaching the end of another long blog. I hope it has been useful to read (whether you are a student, professional, business person, or even a newbie to bOunceT)! Keep an eye out for other ‘News’ posted on our website. Callum 🙂

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