Heatherwood and Wexham Park Hospital trust
The trust delivers acute hospital and mental health services to East Berkshire and the surrounding area: a socially, economically and racially diverse catchment area of 430,000 people. It has an income of£113m.
The trust has embraced the NHS modernisation agenda. Indeed, its chief executive took part in the modernisation action team process and its director of clinical services is a member of Department of Health working groups on resource allocation and consultant contracts.
The trust took part in the first wave of the national booked admissions programme and was involved in the National Patient Access Team national cancer services collaborative programme. It has also set up user groups to reflect the multi-ethnic nature of the population it serves.
The trust put a new management structure in place last summer, moving from 10 'fragmented' directorates to five service groups. The new arrangements have been complemented by a substantial investment in management development.
The trust holds Investors in People and King's Fund organisational audit accreditation. Last year, it completed 49 in-house improvement projects. It has another 66 still ongoing in areas as diverse as managing childhood asthma and tracking down missing outpatient notes.
The judges said:
The trust demonstrated both managerial enthusiasm and a clear record of innovation and achievement. It had clearly grasped and was delivering the modernisation agenda for the benefit of the local community. This is very impressive considering the difficult geographical and social context in which it is trying to deliver.
East Gloucestershire trust
This is a first wave, integrated trust providing services to 250,000 people, with an annual turnover of£120m.
The trust's commitment to involving users - not just patients, but family and carers - has already been recognised by the Health Quality Service and Charter Mark surveyors. But satisfaction surveys, user groups and similar mechanisms have all been tested and overhauled in the past three years.
The trust has a flat management structure and excellent industrial relations. The 1999-2000 staff survey found 78 per cent of staff thought management standards were good, and 67 per cent felt valued by their managers.
East Gloucestershire trust has well-established systems for reviewing clinical practice, quality and performance but continues to improve them.
Recent initiatives include a specialty-specific clinical risk system in theatres, computerised links to GPs for tests and a maternity assessment centre for women at high risk. This reduces the need for hospital stays. The trust participates in all four confidential inquiries and has medical negligence claims running at two-thirds the expected rate.
The judges said:
The trust demonstrates a continuous record of achievement that is impressive. From a culture perspective, there is a positive feeling - staff feel valued. It is a national exemplar for its work on cataracts [the trust has streamlined the patient pathway in cataract services and won a Nye Bevan regional award for this work].
Sandwell Healthcare trust
This trust provides services from the 557-bed Sandwell General Hospital, the new and purposebuilt Rowley Regis Hospital and a number of community bases.
The trust is a partner in a firstwave health action zone and its aims include helping GPs to deliver better services, involving local people, improving services for people with ethic minority backgrounds and investing in people.
Its record of delivering includes increasing the number of traditional hospital services available in the community, working with users to improve services for disabled people, and developing a cultural competence framework to give users equal access to services.
The trust carried out an opinion survey to determine staff views of management. It showed most staff were positive about their managers but highlighted a need to reinforce trust objectives and direction. A communication action plan has been drawn up to address this.
The trust takes part in external accreditation schemes and has embraced the new clinical indicators as a 'positive catalyst to achieve improvements in services'.
The judges said:
Impressive achievements, particularly in terms of staff development and partnership. In particular, we would cite the nursing cadet scheme. [Sandwell Healthcare trust has 65 nurse cadets who work as modern apprentices for two years.
They are financed through nursing degrees and return to guaranteed jobs at the trust]. It is also good at addressing the needs of ethnic minorities.