Evidencing the contribution of social enterprises to health and social care

In the context of the persistent growth of societal needs and health inequalities, innovative solutions embedded in communities have been sought to address such issues. Among community based initiatives, 'social enterprise' has been presented as a potentially innovative and sustainable vehicle for addressing these problems. Social enterprise has been actively encouraged by government as a provider of public services, particularly in the health and social care sectors. However, to date, little empirical research has been undertaken concerning social enterprise and its contribution to health and social care, most likely due to the absence of comprehensive and rigorous academic processes for evaluating social enterprise in a health context. This thesis contributes to the development of these processes by assessing the feasibility of applying methods commonly used in health systems and public health research to the evaluation of social enterprise. Three different methods are adopted. A systematic literature review presents evidence of the impact of social enterprise in comparison with the usual care providers. A 'realist evaluation' and a feasibility study using quasi-experimental design were also conducted to investigate the operation of a specific social enterprise in rural Scotland. The study's contribution to knowledge is threefold. First, it represents one of the first attempts to assess the feasibility of these methods for analysing the contribution of social enterprise to health and social care. Drawing together the findings (and learning) arising from all three phases, recommendations for broadening and developing the evidence base are developed. Second, it is one of the first studies to explore the contribution of social enterprise to health and social care through empirical research. Third, the results of this study not only explore how best to adapt methods to the evaluation of social enterprises by building upon the barriers and limitations faced across the research, but they also contribute to the knowledge of the possible value that social enterprises can provide in health and social care settings.