A major teaching hospital is to hive off its orthopaedic services into an “autonomous team” within the trust as part of a pilot designed to improve staff performance and outcomes.
University Hospitals of Leicester NHS Trust will attempt to give staff a greater sense of ownership over their work by moving the elective orthopaedic, trauma, and theatre teams into their own “business unit”.
“We are experimenting with devolving as much power and decision making as possible to the front line”
The initiative, designed to ape the structure of a social enterprise, is the first step of a long term process that could see the provider eventually become a “whole trust mutual” – outside of state ownership.
Trust chief executive John Adler told Nursing Times’ sister title Health Service Journal that if the pilot improved performance, other services would also have decision making devolved to them.
Currently, the trust’s elective and trauma orthopaedics income is around £48m a year and direct costs for the provider’s musculoskeletal and specialist surgery clinical management group are nearly £28m a year.
In 2014-15 the trust had a total revenue of £834m, according to its most recent board report.
Mr Adler said: “We’re pursuing our autonomous team pilot – essentially an internal spin-out of orthopaedics but very much still within the trust.
“We are experimenting with devolving as much power and decision making as possible to the front line to see what benefits that brings,” he said.
“There’s another few months of development work to do on that before we go live but it will be an exciting pushing of the normal organisational boundaries,” he added.
While the best way to create the autonomous team is yet to be decided, a report produced by trust as part of its involvement in the Mutuals in Health pathfinder scheme suggests two options.
First, the autonomous team could be created as a separate “business division” within the trust. Alternatively, another approach would involve setting the team up as a subcommittee of an existing board committee.
Trust managers have emphasised staff assigned to the team would see no changes to their terms, conditions or access to the NHS pension scheme.
Trust pathfinder report and information provided to HSJ