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Major hospital trust 'very interested' in becoming a social enterprise

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One of the largest hospital trusts in the country has revealed to LGC’s sister title Health Service Journal it is “very interested” in exploring becoming a staff owned social enterprise.


John Adler, chief executive of University Hospitals of Leicester Trust, told HSJ the £760m turnover organisation wanted to pursue a mutual model in order to bolster staff engagement, as a potential alternative to becoming a foundation trust.

His comments come as a Department of Health commissioned report on staff engagement today recommended acute trusts should be free to become staff led mutual social enterprises.

Mr Adler, whose trust employs over 10,000 people, said: “At UHL we are very interested in pursuing this model, either as a variant of or an alternative to foundation trust status. That’s because we believe that it will help to sustain the improvements to staff engagement that we have already achieved.

“With the right leadership, social enterprises have been shown to work well in the NHS community sector and the same benefits should be realisable in the acute sector.

“It’s all about strengthening the voice of frontline staff so that they more directly influence what the organisation does and feel more valued. And as the report [published today] shows, staff who feel more valued deliver better care.” 

Any move by a trust to become a social enterprise outside of state ownership – and subject to less control by the state – is likely to be highly controversial.

Mr Adler was a member of the panel that led the review into NHS staff engagement and empowerment published today. It was commissioned by health minister Norman Lamb and led by King’s Fund chief executive Chris Ham.

Mr Lamb told HSJ the mutual social enterprise model could “very much [be] potentially an alternative” to gaining foundation status for trusts.

However, while the DH has welcomed the report, HSJ understands it does not plan to respond by allowing acute trusts to become mutuals in the immediate future.

Instead, it plans to identify around 10 organisations, including acute providers, to pilot greater engagement of staff. There will be £1m available for the initiative, jointly funded by the Cabinet Office and DH.

The programme will begin this summer and last until next spring. It is understood the DH will use the work to identify regulatory, legal and practical steps it could take to allow new ownership and governance models in future.

In an opinion piece published on today Professor Ham, who chaired the review panel, said there should be an “option… for NHS trusts to become staff led mutuals… including trusts providing acute services”.

He said another approach could see “emerging models of integrated care choosing to become mutuals where several organisations come together to create a joint venture to deliver services such as urgent care and care for older people”. The report said this should be voluntary for trusts.

Professor Ham was commissioned to examine staff engagement and empowerment in the NHS.

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