The transition from primary care to independent provider

“Why do it?” is a question that has been asked by numerous parties during our protracted transition from a primary care trust provider, through judicial review, to actually transferring the services and becoming the first right to request, staff share-owned community interest company, on 1 June 2010.

The assumption at the time that a precedent had been set and paths created by others also became part of the “why”. If they had done this why not us? So we joined the policy dots together for some self-determined change through our committed community clinicians and services managers.

“Why do it? You will be on your own” was a frequent question (and answer). In today’s world, this now looks less likely. The political movement for these developments has taken a positive turn towards a central acceptance that maybe these types of organisations have an important place.

A clear indicator of this new right to provide movement is the development of a new type of staff-led co-op/mutual movement, or the John Lewis approach, as many papers have badged it - within what certainly looks like nearly all parts of the public sector, even Whitehall.

However, one thing is for certain among all these potential developments and growth in the diversification of providers. The central question of “why do it?” will not go away for any of them, especially not from staff side.

The question “why?” now forms a positive cornerstone of our organisational development, “Moving Forward”.

Systems need to be challenged and staff, teams, clinicians and managers need to ask over and again: why are we doing this? Why don’t we do this differently?

Since 1 June 2010 “Moving Forward” has been the key phrase for our organisational development, which aims to have quality care, staff empowerment and engaged users at the heart of all we do.

To date the programme has attracted more than 600 comments and suggestions about what changes people would like to see. Our business units are working these up into action plans. The first rule of engagement is that you cannot ask for ideas and then not act and feed back on them.

The next phase is “Securing our Future”. This system’s thinking process is designed to show our dedication and commitment to staff and services and to taking City Health Care Partnership CIC forward.

It is also designed to build into the notion of further engaging and motivating staff through a £1 partnership share scheme - co-ownership.

A good corporate governance structure is essential to the business. Co-ownership is not co-management and an organisation needs to be both led and managed strategically.

One thing is for certain: without a strong and persistent management team, a team that is now focusing these skills and attributes on the future, we would still be reactively defending and answering, stuck with the negative side of “why?” rather than trying to get on with improving the day job.