Social enterprise is becoming an increasingly prominent feature of health and social care policy. In 2010, the Department of Health white paper pledged to create the ‘largest and most vibrant social enterprise sector in the world’ and NHS staff are being encouraged to set up independent social enterprises to deliver health and care services. In England, the £100m Social Enterprise Investment Fund (SEIF) was established by the Department of Health to support new and established social enterprises to deliver innovative, diverse and responsive services. This paper presents emerging findings from an evaluation of the SEIF. Drawing on national survey and case study data, it presents empirical material on SEIF investees, including an examination of the outcomes being achieved by the fund and an analysis of the barriers faced by the organisations. The paper analyses the prospects and pitfalls of the SEIF in relation to reform and innovation within health and social care services