Increasing autonomy in publically owned services: The case of community health services in England
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 21 September 2015
Abstract
Purpose
The purpose of this paper is to explore government efforts to enhance the autonomy of community health services (CHS) in England through the creation of Foundation Trusts status. It considers why some CHS elected to become nascent Community Foundation Trusts (CFTs) while others had not and what advantages they thought increased levels of autonomy offered.
Design/methodology/approach
Data are drawn from the evaluation of the Department of Health’s CFT pilot programme. Participants were purposively selected from pilot sites, as well as from comparator non-pilot organisations. A total of 44 staff from 14 organisations were interviewed.
Findings
The data reveals that regardless of the different pathways that organisations were on, they all shared the same goal, a desire for greater autonomy, but specifically within the NHS. Additionally, irrespective of their organisational form most organisations were considering an almost identical set of initiatives as a means to improve service delivery and productivity.
Research limitations/implications
Despite the expectations of policy makers no CFTs were established during the course of the study, so it is not possible to find out what the effect of such changes were. Nevertheless, the authors were able to investigate the attitudes of all the providers of CHS to the plans to increase their managerial autonomy, whether simply by separating from PCTs or by becoming CFTs.
Originality/value
As no CFTs have yet been formed, this study provides the only evidence to date about increasing autonomy for CHS in England.
Keywords
Acknowledgements
The authors would like to acknowledge the efforts of Simon Turner and John Wright who undertook the first 13 interviews. This paper reports research from an independent report commissioned and funded by the Policy Research Programme in the Department of Health. The views expressed are not necessarily those of the Department.
Citation
Cameron, A., Allen, P., Williams, L., Durand, M.A., Bartlett, W., Perotin, V. and Hutchings, A. (2015), "Increasing autonomy in publically owned services: The case of community health services in England", Journal of Health Organization and Management, Vol. 29 No. 6, pp. 778-794. https://doi.org/10.1108/JHOM-06-2014-0098
Publisher
:Emerald Group Publishing Limited
Copyright © 2015, Emerald Group Publishing Limited