CSH Surrey is an employee-owned, not-for-profit NHS community healthcare provider. Since 2006 the organisation has worked in partnership with the NHS and social care in homes, clinics, hospitals and schools to transform local community health services.

CSH Surrey started out as Central Surrey Health, when a group of more than 560 nurses, therapists and support staff chose to leave the NHS in 2006 and set up their own not-for-profit social enterprise – believing they could provide higher quality healthcare services by combining the core values and principles of the NHS with the entrepreneurial ‘can do’ culture of a successfully run business.

As an NHS provider registered with the Care Quality Commission (CQC) and a company limited by shares and registered at Companies House, CSH Surrey has clear minimum or essential standards to achieve as an organisation, which include financial, health and safety and data protection.

CSH Surrey has established a community fund where they distribute surpluses from efficient operations in the community. Since 2012, CSH Surrey has awarded more than £55K in grants to local charities.

In 2017, as a result of retaining its existing contract and winning new contracts, CSH Surrey doubled in size.

The John Lewis Partnership is the UK’s largest employee-owned business and parent company of John Lewis & Partners and Waitrose & Partners, which are owned in Trust by over 80,000 Partners. There are 50 John Lewis & Partners shops plus one outlet and 337 Waitrose & Partners shops across the UK. The Partnership also has two international sourcing offices, a soft furnishings factory, various distribution centres, three Waitrose & Partners cookery schools, a content production hub, heritage centre and its own Waitrose & Partners farm.

The Partnership was founded over a century ago by John Spedan Lewis who began an experiment into a better way of doing business by including staff in decision-making on how the business would be run. With 83,500 employee owners – called Partners – the John Lewis & Partners is the UK’s largest employee-owned business.

The commercial strategy of the John Lewis Partnership is differentiation, not scale. It invests in its point of difference of employee-ownership.

Its democratic network of elected councils, committees and forums enables Partners to participate in decision making, challenge management on performance and have a say in how the business is run. The Partnership Council represents all Partners, reflecting their opinion, to ensure the business is run for and on behalf of all Partners. It shares responsibility for the Partnership’s health with the Partnership Board and the Chairman. Its role is to hold the Chairman to account, influence policy and make key governance decisions.

Community Dental Services (CDS) is a small community dental service that formed in 2011 under the UK Mutuals Program “Right to Request”. With the help of a nationally funded Transition Director, CDS staff were supported to “spin out” from a large NHS Community Trust. A union staff vote was held to determine if the transition would proceed. 78% voted to transition.

CDS is 100% employee-owned and employs 487 people across 65 clinics. As a social enterprise, CDS trades and makes a profit for a social purpose. After investments, 10% of any surplus made each year is redistributed equitably to the business and local charities. This includes funding for performance bonuses distributed equitably to all staff. CDS has established CDS Action as a charity that receives donations from any CDS surplus each year.

Services are mostly commissioned by NHS England and Local Authorities to deliver NHS dental care and oral health promotion advice across a diverse range of communities. CDC services are commissioned by the Local Authority.

In addition to its clinics, CDS also provides mobile clinics, prison dental services, oral health clinics and services in people’s homes, retirement villages and care homes.

Employee engagement is a key part of the CDS governance model. Employees are represented in governance at the local level through to employee elected directors on the Board.

In 2014 RAC commenced a formal partnership with a Disability Employment Services (DES) provider to establish a supportive and targeted approach to employ people identifying with a disability. The following year, RAC launched a formal diversity and inclusion strategy and embraced a new culture heavily focussed on behaviours. This holistic approach established strong foundations to accelerate RAC’s commitment to increasing employment opportunities for people with disabilities.

RAC has since employed 20 people through DES providers, creating a positive culture change across the organisation.

Jenelle was employed by RAC straight out of high school through RAC’s partnership with Edge Employment Solutions.  She joined the People Services team under the guidance and support of her Leader, Leesa. For the last five years, Jenelle has worked as a HR Administration Assistant with duties that include filing, archiving, organising staff memberships and the files for new starters.

Leadership was critical to the success of people joining RAC. The organisation supported its leaders who demonstrated strong inclusivity and who showed courage to step-up and learn from working with someone with a disability by focussing on their talent.

During her time with RAC, Jenelle has overcome her shyness and developed a lot of confidence. Jenelle has participated in a number of corporate volunteering events including car washing for the Cancer Council WA, potting for Trillion Trees, and cooking meals for the residents of Ronald McDonald House and the Cancer Council’s regional residents. The highlight of Jenelle’s career with  RAC has been her nomination as a finalist for the organisation’s annual Look Out for Each Other Award for workplace safety.

Jenelle credits her success at work, to Leesa as “an amazing leader who goes out of her way to make me feel valued at work and outside work”.

Jenelle’s success in the role has been achieved through her will to develop, participation in all team and Social Club events, strong organisational leadership and an inclusive team culture.

RAC has established an Enabling All Abilities Working group to accelerate the organisation’s work to becoming more inclusive for people identifying with a disability.  Led by the General Manager of HR with the executive sponsorship of RAC’s Chief Operating Officer, the team has three objectives:

1. Employability – Increase employment opportunities for people identifying with a disability
2. Accessibility – Improve accessibility for RAC people, Members and customers (physical and digital)
3. Advocating for Inclusion – Increase education and awareness for RAC leaders and RAC employees

Indications of RAC’s progress for a diverse and inclusive culture has been provided through the recent appointment of several people with disabilities who have applied directly to RAC and not through a DES provider.

In 2019 the RAC team have continued to achieve progress on all objectives by:

• Employing 10 people (3 through direct applications);
• Working with four DES partners;
• Removing doors that were unnecessary barriers;
• Conducting a building accessibility audit; and
• Continuing to share the stories of their All Abilities Ambassadors.

We’re on the journey – from good to great; from intent to impact – RAC!

In the early 1970s the inner-Sydney suburb of Redfern was “really, really racist”, says resident Sol Bellear, of the Bundjalung people, far north New South Wales coast. To receive medical care, “you had to pay two dollars to attend the emergency department. If you were Aboriginal you might sit there for half the day and not be seen.”

Hundreds of Aboriginal people were arriving in Redfern in this period, and encountering bitter discrimination. “Only one pub would serve Aboriginals – the Empress Hotel. Of course it was the perfect place for the cops to come.” Yet this was also an era of feminist, student and trade union activism. Sol was an organiser for the Builder Labourers Federation, one of the most visionary organisations of the period. Together with allies from those movements, in 1971 Aboriginal activists were ready to create a health service with “Aboriginal
community control at all times”.

The iconoclastic eye specialist Fred Hollows lent a hand, along with medical students and GPs donating time from private practice. For its first 18 months the Aboriginal Medical Service (AMS) ran entirely on donations. Then funding began to arrive and a legal structure was needed. “We looked at the Co-operatives Act and it gave us everything we needed,” says Sol, the current AMS chair. “A co-op was the only structure that we could go along with. It suited us down to the ground.”

The first-ever Aboriginal community-controlled health service in Australia celebrated its 40th anniversary last year, in stronger shape than ever. It now offers full primary and preventative health care programs, still for the original fee of one dollar a year. The main medical and dental clinics are supplemented by a diabetes clinic named for Sol’s brother Bob Bellear, the first Aboriginal judge and an early AMS director, who died of asbestos-related disease in 2005. The drug and alcohol clinic stands across the road to “provide that bit of anonymity”. An HIV-AIDS prevention program, using Aboriginal footballers to get its message across, was so effective that AMS now advises African countries on dealing with the epidemic.

From the start AMS treated its patients with a holistic approach. “If someone had a chipped tooth, we’d take their blood pressure.” That approach is still followed, and staff members go to the markets weekly to buy fresh fruit and vegetables and deliver them free to at-risk people. Emotional and mental health is another area of constant concern. Dr Marie Bashir was an AMS psychiatrist in the late 1990s and today, as New South Wales Governor, maintains her involvement with the Service.

AMS is now joined by 200 Aboriginal medical services throughout Australia, and is the busiest of them all. “These days we also treat some non-Aboriginal people, such as pensioners,” says Sol. Its co-operative structure remains a vital feature. “Co-ops are well suited to Aboriginal people because of our kinship tradition – everything is shared. For our people, co-operatives have been a godsend.”

This case study was first published in the International Year of Co-operatives Australia 2012 book – Building a Better Australia: 50+ stories of co-operation.

In 1954, nine-year-old Vivi Germanos-Koutsounadis and her family arrived in Sydney from Greece. “It was a very traumatic experience. I was the only migrant child in my school. My mum and dad came to Australia to get us a better education, but I couldn’t understand the language so I was put in the lowest classes.” Even so, she says, “I value those experiences. They made me more caring. Afterwards, more migrant girls came and I was their guardian.”

Vivi has acted as the guardian for recent and troubled migrants ever since, and is now executive director of Sydney’s Ethnic Child Care, Family and Community Services Co-operative (ECCFCSC).

She helped form the co-operative in 1978, in response to the childcare needs of non-English-speaking migrants. For many members of these communities, private childcare centres were too costly and not culturally or linguistically suitable, so their children were often left at home alone, or in private homes with untrained carers. Finally, government funding was provided to seven ethnic communities for dedicated childcare services, and the ECCFCSC acted as their co-operative umbrella group.

“The centres needed bilingual people to help them with cultural competence,” Vivi remembers. “So we trained migrant women to work with the staff. They were Chinese, Indian, Arabic-speaking, and many of them had professional qualifications, but they were working as cleaners. We gave them the opportunity to fulfil their dreams.”

These bilingual advisers worked with newly arrived children and explained their religious and cultural practices to childcare staff. “One little boy kept crying and he wouldn’t speak, so the staff were very worried. One of our workers spoke Arabic to him and he spoke back for the first time.”

From its first years, the ECCFCSC was one of the groups helping to build the Addison Road Centre, a former army barracks that became Australia’s largest not-for-profit community centre, housing dozens of ethnic and arts, cultural, community and environmental groups. “I was president of the centre,” says Vivi, “and we still work from there.” She has not forgotten the help her group received from Vivien Abrahams, a solicitor, and Helen McCall, a financial administrator who later headed the Co-operative Federation of NSW.

“They had such passion for the co-operative movement.”

ECCFCSC membership has increased to more than 50 non-profit community organisations and now works not only in childcare, but also with the disabled and aged members of ethnic communities. “Some elderly Bangladeshi people could no longer cook for themselves, but they didn’t like the Meals on Wheels. So we brought them to a Bangladeshi community centre where the meals were specially prepared for them. They loved them, and when they were asked if they wanted the same food delivered to their homes, of course they were delighted.”

To Vivi, a co-operative is the natural structure for a group like ECCFCSC. “That’s what we do – co-operation. People here are sharing and learning from each other – they have similar issues. I think a co-operative can bring people a lot closer together.”

This case study was first published in the International Year of Co-operatives Australia 2012 book – Building a Better Australia: 50+ stories of co-operation.

Although traditionally stereotyped as ‘moccasin-wearers’, the people of Melbourne’s western suburbs can claim a unique distinction. In 1980 a group of residents in this low-income area took the initiative to develop their own community-controlled medical service. That initial one-GP service was underwritten by the social services department of Victoria’s Baptist Union Church. After six years it could operate independently, and Westgate Health became the first registered community advancement co-operative of its kind in Australia.

Starting with that first small clinic in South Kingsville, the co-operative expanded by acquiring a second just a few kilometres away in Newport. They currently employ 11 doctors (some of them working part-time), as well as dentists. Additional services are provided through a physiotherapist, acupuncturist, two psychologists – one specialising in child psychology – a diabetic educator and an audiologist.

For this comprehensive and affordable service, the co-operative’s 5500 members pay a one-off joining fee of $30 per family, then an annual fee of up to $50 per person or $90 per family, with significant discounts for beneficiaries.

Those modest fees (which even provide for a free annual dental check-up) enable Westgate Health to run with no state or federal funding. At times  Westgate has supplied other services more usually regarded as community development, such as free transport, counselling and a ‘casserole bank’ for patients, particularly mothers.

Peter Cash began working as Westgate’s part-time accountant several years ago, eventually joining its board and serving as chair. “You do get the impression of a general atmosphere of community involvement that permeates the whole establishment. Our doctors certainly find there’s a difference to private practice. They’re able to focus on patients rather than the bottom line.”

Some of those patients are referred from as far away as Footscray, says Peter, if they have special needs that Westgate is best placed to provide. This may mean using a translator to communicate with them in minority languages such as, recently, a dialect of Burmese. “We’re now looking at opening a third clinic in Laverton, an area of real need with poor public transport and inadequate social housing.”

It’s not always straightforward working as a community-owned and -run service, and Westgate has encountered difficulties in involving its broad and multilingual membership. “We’re updating our database and developing a PR front to encourage people to come forward,” says Peter. “It’s a defect we recognise.”

As the first medical service of its kind in the country, Westgate Health was crucial to the subsequent formation of Canberra’s West Belconnen Health Co-operativeand remains willing to support other communities looking to follow its example. As its website states, “The philosophy of Westgate Health is based on the principles of co-operation: co-operation between patients and health professionals in caring for the health needs of the community, and co-operation between staff, management and co-op members in the governance and support of the organisation”.

This case study was first published in the International Year of Co-operatives Australia 2012 book – Building a Better Australia: 50+ stories of co-operation.