NHS staff may gain from John Lewis model

Foundation trusts should also consider developing a “chambers type arrangement” to give clinicians greater control, the Nuffield Trust report suggests.

It says better staff engagement in the NHS could improve productivity, but policies have consistently failed to make a significant impact.

It says: “Policy aspirations have yet to be turned into practice on a consistent basis. This suggests that more than exhortation and guidance are needed to convert policy into practice.”

The report - NHS Mutual, Engaging Staff and Aligning Incentives to Achieve Higher Levels of Performance - proposes a range of ideas. These include creating “professional partnerships” like Circle and Kaiser Permanente, or limited liability companies such as Central Surrey Health, where each staff member has a 1p share.

Alternatively shares can be owned or held collectively by a trust for the benefit of employees, as at the retail chain John Lewis Partnership.

On average, staff productivity is increased by 4 or 5 per cent when employee ownership is introduced, the report notes.

The recommendations follow criticism that the next stage review has focused on leadership skills but made little impact on staff.

Author Chris Ham said: “Another speech from [Department of Health director general of workforce] Clare Chapman or more guidance on staff engagement isn’t going to work.

“The fact that Clare Chapman is giving speeches today that hark back to her predecessor suggests we have to be rather more radical in looking at things.”

Ms Chapman rebutted the claim she was not being radical enough: “The constitution pledge around involvement and engagement is a reflection of deep consultation with staff, patients and the public,” she said.