Fair work

Business support and fair work

A better balance: business support for the foundational economy (2021).

Jack Watkins. The Institute of Welsh Affairs and Centre for Regeneration Excellence Wales.  

A review of business support policy and practice of Business Wales, the Development Bank of Wales and Welsh Government and opportunities for changes to better support the foundational economy – ensuring grounded Welsh firms can receive necessary support to supply high quality everyday goods and services. Authors find that current support has positive impacts however only reaches a minority of Welsh firms, because it is often targeted at high-growth firms and particular sectors. Thus, the current support currently does not effectively support micro-firms to become successful and sustainable SMEs – a key part of a healthy foundational economy. Authors suggest measures for policy makers could take to make business support work for the foundational economy better.  

Download the paper from The Institute of Welsh Affairs and Centre for Regeneration Excellence Wales on business support for the foundational economy

Fair work in the foundational economy: what should be done (2021).

Victoria Winckler. Bevan Foundation.   

A report bringing together key findings from work previously published by the Bevan Foundation on experiences of working within some sectors of the foundational economy and an international review of promising policy and practice to approaches to fair work. It shows that work in the foundational economy is often of low quality including low pay and low hours, highlighting a need to improve terms and conditions. Drawing lessons from the international review, the report makes recommendations for a range of actors including policy makers, local government, Business Wales and the Development Bank for Wales to support fair work within the foundational economy.  Authors use The Fair Work Commission in Wales’ components of fair work; fair reward, employee voice and collective representation, security and flexibility, opportunity for access, growth and progression, safe healthy and inclusive work and that legal rights are respected and given substantive effect.  

Download the paper from the Bevan Foundation on fair work in the foundational economy

Fair work in the foundational economy: key data (2021).

Anne Green and Paul Sissons. Bevan Foundation.  

Download the report from the Bevan Foundation for key data on fair work in the foundational economy

The impact of regulation in the foundational economy (2021).

Jack Watkins and The Means. The Institute of Welsh Affairs, Centre for Regeneration Excellence Wales and The Means.  

An outline of the effect of current regulations and their enforcement on Welsh small and medium firms of the foundational economy. Authors use interviews with business owners in construction, social care, food and manufacturing demonstrating confusion over rules, the complexity of overlapping requirements and overly rigid enforcement. The report outlines how regulation and enforcement can disproportionately impact small and medium sized business, causing difficulty for new businesses to be successful. Authors make a series of recommendations for regulatory bodies, including Welsh Government and local authorities to help support small and medium sized businesses of the foundational economy.  

Download the paper from the Institute of Welsh Affairs, Centre of Regeneration Excellence Wales and The Means on the impact of regulation in the foundational economy

What can Welsh Government do to increase the number of grounded SME firms in food processing and distribution? (2021).

Andrew Bowman, Julie Froud, Colin Haslam, Sukhdev Johal, Kevin Morgan and Karel Williams. Foundational Economy Research.   

An analysis of the Welsh food system from field to fork and the business models of SMEs which form a part of this system, with recommendations on a range of coordinated policies to secure and increase the number of grounded Welsh SMEs processing and distributing food. Authors define a Welsh grounded SME as an SME which is independently owned in Wales with a high proportion of assets in Wales. Authors argue specific policies are required for the specific characteristics of every food system, including Wales. They put forward a number of priorities to move forward; one, engage supermarket chains in a greater effort to recruit Welsh SME suppliers, two, effectively use public procurement to create demand side opportunity and finally maintain and consolidate infrastructures to support Welsh food SMEs. 

Download the paper from Foundational Economy Research on what the Welsh Government can do to increase the number of grounded SME firms in food processing and distributing

Community Care Collaborative: Transforming Primary Care in Wrexham

The Community Care Collaborative (CCC) is a Community Interest Company that provides an innovative and integrated approach to healthcare in Wales.

Founded by Dr. Karen Sankey in 2018, CCC developed a very clear vision for primary care after realising that the current model was failing at several levels.

Through research and testing, it found that patients often visit a doctor with an issue that has a social or mental health basis, which it believes GPs are not equipped to deal with in the best way.

Added to this, it’s thought that the volume of patients that a GP is expected to see in a day on top of other duties such as medicines, makes it impossible to provide an adequate service to every single person.

The solution is a model which delivers “an alternative model of health, social care and wellbeing in which GPs (doctors) are able to focus on providing medical care, and where, through working collaboratively at a community level with other agencies and patients themselves, the social and emotional needs of patients are given equal priority to their medical needs”, as its mission statement shares.

“The Challenge Fund seemed to me to be very much about trying to do things differently and about taking a chance to really give something a go to find out whether it works or not.”

Before receiving a Challenge Fund grant, CCC had already secured contracts to trial this model at three GP practices in Wrexham and had been granted permission to take over its first practice in September 2019 with the second and third following in January and April 2020.

However, the Challenge Fund grant has been essential in enabling CCC to develop its ideas further and successfully set up and recruit in a vast number of different areas of health and social care over the last 12 months.

Alison Hill of Capacity Lab, who assisted in bringing the model to life said that, “The Challenge Fund seemed to me to be very much about trying to do things differently and about taking a chance to really give something a go to find out whether it works or not.”

Firstly, CCC recruited a permanent emotional wellbeing team which is present at all three practices and aims to provide a first point of contact for patients that are in need of wellbeing support directly after booking an appointment.

What commonly happens in these cases is patients are referred on to other mental health organisations and can bounce back, so a key focus of this team is to reduce onward referrals by providing services in-house such as support groups, medication reviews, memory assessments and psychotherapy.

The organisation has seen that utilising this model alone has seen onward referrals reduce by over 57% compared with the previous evaluation period (Apr-Sept 2019).

Not only does this mean that patients are being provided a more appropriate and immediate response, but the cost savings to other health and social care services are likely to be significant. A social impact evaluation of CCC’s Emotional Well-Being Team found that it had delivered social value worth more than £1million in its first 12 months to November 2020, representing a social return on investment of 6.42:1.

More important to those involved is that 33% of people supported within this model (who were asked for feedback), said that without support they may have taken their own lives, further demonstrating the positive impact that the model is having.

To support the referral process, CCC recognise that as first responders to calls, front desk staff play a vital role in the patient process so it invested in training to develop them into ‘Care Navigators’. People within this role now have the knowledge to respond to individual patient needs and signpost them towards the relevant team, rather than automatically referring them to a GP.

Due to the high level of demand during Covid-19 and the huge upheaval of a system that has been in place for years, the booking system is an area that CCC is still working to make as effective as possible through continuous testing and experimentation.

Alison says, “We tried eConsult (Lite), which didn’t work out so we changed it and adapted it…it’s improving, but that is something that we haven’t got right yet and we still need to work very much on.”

Despite the obstacles faced by the pandemic, CCC is really proud of its progress this year, although there are some areas where work still need to be done, especially in recruiting full time salaried GPs.

Although CCC has been able to employ some part time doctors, Alison explains that a huge obstacle primary care is currently facing is that many GPs are working as temporary doctors known as locums, which she says, “In terms of finances, it’s going to destroy primary care.”

As they move towards the goal of recruiting more full time GPs in 2021, the team is confident that this integrated model will prove attractive to GPs, as it gives them more opportunity to concentrate solely on medical needs and to patients as they will be able to access a much wider range of inhouse support.

As CCC looks towards the future, it will be concentrating its efforts on recruiting full time salaried GPs, and building partnerships from within the Welsh Government’s FECF Community of Practice, as well as other organisations that can help to replicate this model across Wales.

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