In a previous post I talked about the need for the district general hospital to reinvent itself. And the same is true of the university hospital.
It is a truism that there is too muchpreoccupation with organisational status. We have long seen the desire to have ‘teaching’ inserted into trust names but the reality isthat nowadays most NHS organisationsoffer teaching because of the necessity for it to be delivered closer to the communities medicine serves. So the teaching epithetis now commonplace. Hence the search foruniversity status but not in the broadest sense of the term. It should only be granted for FTs linked to biomedical research-based academic institutions because it is at theinterface between biomedicine and clinical services that most gains are to be made in healthcare treatment and healthimprovement. And their respective strategies shouldreflect their inter-dependence and longer-term survival.
Although academic health science partnerships are increasingly in vogue, to optimise the benefits of the relationship between the NHS and HE sectors the real prize for university FTs is to secure the same organisational status and associated freedoms as universities, and equallyimportantly, their arms-length relationship with government. The political moment to pursue that has - unfortunately - probably passed for the FT movement but neverthelessit should remain a long-term goal.
If university FTs accept this view of the future then one implication is to be clear about their future strategy, at the core of which are anumber of pertinent questions. Should university FTs continue to position themselves as enhanced versions of district general hospitals at a time when DGHs have toradically re-think their own strategies in light of the impact of the current reforms?
Furthermore, if the premise is accepted that university FTs exist primarily to develop anddeliver tertiary services should this not be their core strategic driver? And whilst this means that university FTs should not duplicate DGH services it does mean theyshould have links with DGHs for synergistic business reasons.
And the upshot of all this? In the new world it will become almost impossible to pursue other than a wholesystem, relationship-based approach to strategic development. Whether new commissioners can meet this leadership aspiration time will tell.