Hospital groups or chains could improve the sustainability of the NHS

The paper, “NHS Group Models: Working together for a more sustainable NHS”, has been produced by Credo Business Consulting and draws on its experience of working with three of the four Trusts accredited to pursue Group models; the Royal Free London NHS FT, Salford Royal NHS FT and Guy’s & St. Thomas’ NHS FT.

It says that the current system, where providers are often compelled to compete for resources, talent and patients, has created wide-scale variation between organisations, misaligned incentives and duplication, which act to further exacerbate the health inequalities seen across England.

The paper suggests that there are significant advantages of organisations working together at scale. For example, by working as a Group providers can:

  • Provide a platform for identifying and addressing unwarranted clinical variation. Scale enables this by providing the necessary expertise, evidence base, and analytics, which smaller organisations would struggle to replicate;
  • Leverage highly capable leaders with proven track records across an enlarged base, while nurturing and developing ‘up and coming’ leaders through better support mechanisms and improved career paths;
  • Align incentives and remove organisational barriers, thereby enabling leaders to make better decisions at pace that benefit both patients and reduce total system cost;
  • Enable significant improvements in quality and cost through economies of scale, joint procurement, and investment in standardised systems and processes;
  • Support the pooling and sharing of resources (both people and capital) across multiple organisations, resulting in better expertise, higher utilisation, and greater ability to invest; and
  • Enable the workforce to be deployed more flexibly across a wider footprint, resulting in better use of resources, improved responsiveness and an enhanced staff experience.

The report also highlights that there is a spectrum of organisational models for providers to consider, and stresses the need for organisations to design a model that addresses their individual opportunities and challenges and works within their local environment.