The health secretary has appointed Sir David Dalton to lead a team looking at getting trusts to group together into “chains”.

The Salford Royal Foundation Trust chief executive has been asked to investigate what barriers prevent hospitals forming together into larger, non-geographic groups under the “superhead” style leadership system seen in the education sector.

David Dalton

Sir David Dalton will look at the possibility of a ‘success regime’

The idea has been floated before but has never previously been given a policy push on the scale of today’s initiative.

In an HSJ interview, health secretary Jeremy Hunt said he wanted to see an expansion of the “buddying” arrangement between prestigious trusts and those that have been placed in special measures.

Mr Hunt said he would not rule out changes to the law on mergers between trusts or to the foundation trust governance model if Sir David recommended this.

Sir David will consider what incentives can be offered to trusts to undertake turnaround projects and franchises where one NHS brand has hospitals around the country.

The Department of Health said Sir David would also examine the feasibility of “non-geographical chains of hospitals under one leadership team” and “management contracts so that outstanding leadership teams can take on a more formal relationship [with trusts being turned around].”

Mr Hunt told HSJ: “I don’t think it’s primarily a competition issue because if you look at most other countries they have groups of hospitals and they are often nowhere near each other geographically. So what is it that would create the right incentives and structures for somewhere like Salford Royal to take over a hospital in Lincolnshire?”

Sir David told HSJ he had been given a free rein to consider whatever could be done to encourage the spread of better practice between hospitals.

He said this could involve a “credentialing” framework for trusts thought capable of helping to run smaller trusts.

This could see a new classification of elite hospitals, which foundation trust status was once thought to denote.

Sir David told HSJ: “There is the failure regime at one end of the distribution and it is appropriate to have something at the other end – ‘a success regime’ for those organisations that have proven standards and can deliver them reliably.”

The news comes as Monitor and the NHS Trust Development Authority released a report saying hundreds of extra staff had been appointed to the 14 trusts in special measures and that there had been “49 leadership changes”.

The review will sit alongside an examination of NHS leadership being undertaken by former Marks & Spencer boss Sir Stuart Rose.

Sir David’s report is expected to be submitted in the late summer.

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