Acute trusts should be free to become staff-led mutual social enterprises in an effort to improve staff engagement, a Department of Health commissioned report recommends.

The review, led by King’s Fund chief executive Chris Ham, is published today.

In an opinion piece published on HSJ.co.uk today Professor Ham says there should be an “option… for NHS trusts to become staff-led mutual… including trusts providing acute services”.

He says another approach could see “emerging models of integrated care choosing to become mutuals where several organisations come together to create a joint venture to deliver services such as urgent care and care for older people”. The report says this should be voluntary for trusts.

The DH has welcomed the report but HSJ understands it does not plan to respond by allowing NHS acute trusts to become mutuals.

However, the DH is expected to identify around 10 organisations, including acute providers, to pilot greater engagement of staff. There will be £1m funding available for the initiative, jointly from the Cabinet Office and DH.

The programme will begin this summer and last until spring next year. It is understood the DH will use the work to identify regulatory, legal and practical steps it could take to allow new ownership and governance models such as mutual in the future.

Care and support minister Norman Lamb said in a statement: “All the evidence shows that trusts with staff who feel empowered and have a shared sense of ownership perform better.

“Our pioneering areas exploring the idea of mutuals in the acute sector will give us valuable evidence to see how a new form of staff participation could help benefit patients.”

Professor Ham’s review report also calls for a “consistent and proportionate system of regulation and performance management of all providers… based on presumed autonomy”.

The study found that NHS organisations with high levels of staff engagement report lower mortality rates and better patient experience.

An NHS Trust Development Authority spokesman said: “It is essential that any future policies maintain the expected high standards that trusts currently need to meet in order to progress to FT status.”

A Monitor spokesman said: “Monitor has worked hard to ensure that regulation is proportionate at the same time as securing the sustainability of health services and making sure they work in the interests of patients.”

 

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