14.09.16
Successful trusts could become regional leads under new NHSI framework
Under NHS Improvement’s (NHSI’s) new single oversight framework, trusts could be asked to become regional or national leads on issues they excel at as part of a support package for struggling providers, NHE has been told.
Speaking to an NHSI spokesperson before the revised framework was launched, NHE learned that some of the improvement support given to trusts that are not in segment 1 – under the fresh segmentation approach – will be coming from “the sector itself and from other organisations”, as well as from NHSI teams.
Asked what this means in practice, the spokesperson suggested providers should “watch this space”, since it is an ongoing idea still under development.
But because of the way NHSI functions, there will be cases where the organisation will look to source expertise from outside its central and regional teams, and that could very well be a trust who boasts best practice.
A trust that is very good at flow management, for example, “could be asked to be a regional or national lead on flow management and provide some expertise for providers on how you manage patient flows, how you address front room/backdoor problems at trusts”.
“That’s emerging,” he added. “That is an example of how we could use that approach to share best practice across the sector.”
When Jim Mackey spoke as Monitor and NHS TDA were set to merge last year, he had said that the NHS is a good learning organisation, but not always good at spreading its learning across “what is a huge canvas”. That is one of the things the framework is going to allow, the spokesperson stated.
“NHSI will act as a kind of hub or network for getting the NHS to help itself and, more importantly, to spread good practice around,” he added. “It will get trusts to talk to each other, because in many cases maybe they haven’t spoken to other trusts as much as they can, and it will get trusts to really help each other.
“Also, a trust in the north east is more than likely going to have the same problems as a trust in the south west. There may be a few local random variables, but the whole point with spreading good practice is that you take what’s transferrable and then you just tailor it to your local specific regions.”
Asked if this suggestion of looking outside for support could open up the door to the much-discussed “privatisation of the NHS”, the spokesperson said the health service already uses the expertise of the private sector when it can offer something to trusts.
Links with the ‘model hospital’
NHSI also confirmed that the segmentation approach, which divides trusts and foundation trusts into four groups based on their support needs informed by data and insight, will be linked to Lord Carter’s ‘model hospital’.
“As Carter expands the model hospital and the information from that, what we’ll see is that it could begin to inform some of our insights,” he explained, adding that some of the diagnostics embedded in the Carter Review had already formed part of the framework consultation document.
“Given we have now taken on-board the Carter team, they’re now expanding within the organisation, there will be linkages between this approach and the model hospital over the next 12 months.”
Connecting providers to the Carter ‘model hospital’ standard won’t be carried out through a laissez-faire approach, where trusts are left to their own devices to achieve Carter-based benchmarks. Instead, trusts that need more targeted support will probably be “nudged” to look at some of the benchmarks – despite these still being under development at present and not yet on offer in a more robust, usable form.