A Comparative Analysis of Social Impact Bond and Conventional Financing Approaches to Health Service Commissioning in England: The Case of Social Prescribing

Abstract

The article compares two social prescribing interventions in Northern England. One was financed through a Social Impact Bond (SIB) and the other was financed in a more conventional way. It utilises a comparative approach to understand the extent to which different methods of financing social prescribing conform to key features of the New Public Management (NPM) or New Public Governance (NPG) in their design and implementation. It finds that a SIB approach tends towards NPM during programme design and implementation and that this creates challenges for social prescribing programmes, the complexity of which appear better suited to an NPG-based relational approach.

Keywords:

• social impact bonds
• social prescribing
• New Public Management
• comparative governance
• qualitative methods

Acknowledgements

Some of the findings in this paper are derived from independent research commissioned and funded by the NIHR Policy Research Programme through its core support to the Policy Innovation Research Unit (Project No: 102/0001). The views expressed in the publication are those of the authors and are not necessarily those of the NHS, the NIHR, the Department of Health and Social Care, its arm’s length bodies or other government departments.

Additional information

Funding

This research was funded in part through the NIHR Policy Research Programme (102/0001).

Notes on contributors

Chris Dayson

Chris Dayson is a Principal Research Fellow at the Centre for Regional Economic and Social Research, Sheffield Hallam University. His research focusses on the role of small local non-profit organisations in the implementation and governance of public services. Currently he is exploring the value of small local providers and how initiatives such as social prescribing can enable them to play a more active role supporting mainstream policy goals.

Alec Fraser is an Assistant Professor in Public Policy & Management at the London School of Hygiene and Tropical Medicine in the UK. He has a strong interest in the interaction of evidence, policy and politics and how these factors impact upon public service delivery.

Toby Lowe is Senior Lecturer in Public Management & Leadership at Newcastle Business School, Northumbria University. His research focusses on the funding, commissioning and performance management of social interventions, using complexity theory to reflect critically on the application of New Public Management approaches to complex service environments.