Search results

The development of NHS trusts has been a major part of the NHS reforms in the United Kingdom. The creation of trust boards has coincided with significant pressures from the combined forces for change and consolidation within publicly financed health care in the UK. The development of a long‐term strategic vision for trusts to ensure long‐term survival is imperative. Considers evidence from international researchers and translates this into the context of NHS trusts. Discusses how they define and identify vision and ensure that vision building can be communicated and understood by key stakeholders within and outside the organization. Offers several practical suggestions on how their vision can be monitored and evaluated within the organization.

This article has been withdrawn as it was published elsewhere and accidentally duplicated. The original article can be seen here: 10.1108/09552069810239263. When citing the article, please cite: Mark Hackett, (1998), “Developing consultant care on delivery suite”, Health Manpower Management, Vol. 24 Iss: 6, pp. 229 - 233.

The new NHS White Paper (DoH, 1997) provides for a new legal duty of quality for chief executives in Trusts. Clinical governance is seen as a central tenant of this legal duty which is designed to raise clinical quality to the same level of importance as corporate governance.

The development of locality commissioning models combined with demographic, therapeutic and service changes are driving new professional relationships between general practitioners and acute Trusts. To ensure a Trust releases its strategy in this environment, stakeholders must understand the benefits to be gained from these new levels of relationships. A review of the literature is undertaken and the conditions for successful partnerships between acute Trusts and general practitioners defined. The article determines that for acute Trusts it will mean an examination of core competences combined with a drive to “review” their organisations.

The role of the chief executive in a transformed organisation is an extremely challenging one. The development of vision, building a commitment to it and communicating it constantly are key skills for a chief executive. However, the need to build and empower the stakeholders within and outside the organisation to support the changes required to deliver the vision requires leaders who can connect with a wide range of people and build alliances and partnerships to secure organisational success. A passion for understanding human intervention and behaviour is needed to encourage, cajole and drive teams and individuals to own and commit to change and a new direction. This requires leaders who have imagination and creativity ‐ who seek connections and thread them together to create order out of incoherence. These skills are not taught in schools or textbooks, but are probably innate. They are what separate leaders from the rest. These skills need to be developed. A movement towards encouraging experimentation, career transfers and more individuality is needed if capable leaders of the future are to appear.

The success ofThe need to develop a consultant presence on the delivery suite has never been greater given the emerging quality agenda that is occurring within the speciality. This is identifying a clear impetus for changing consultant practice and also meeting the needs of women more effectively. The article describes these trends, the impetus for change and identifies practically how such a change was achieved within the largest women’s hospital in the UK. It defines the basis for building a vision for an improved future and the practical use of management and transformational leadership skills to change consultant behaviour and attitudes with a clear set of outcomes that were achieved.

The implementation of clinical governance presents a major challenge for NHS Trusts. The article provides a summary of the background to implementing governance; the results of locally organised research in an NHS Trust reveals clinicians’ perceptions and attitudes to implementing clinical governance and the lessons for NHS chief executives. The research provides a valuable insight into the implementation issues which Trusts need to address and the basis for trying to address these in their own organisation.

The delivery of effective postgraduate education for doctors in trusts is becoming vital to secure the individual services of trusts. Increasingly, training requirements are impacting on the location of clinical services that NHS trusts provide. Failure to understand the benefits and drawbacks of providing postgraduate education could affect the long‐term strategic direction of trusts. The paper seeks to identify the case for investment, the need to address key deliverables to secure effective postgraduate education and the need for clinicians and managers to evaluate the effectiveness of such training for their organisations.

The role of consultant obstetricians is under considerable debate. This has particularly focused on the role of consultants in intrapartum care. The article explores the role of the consultant in delivery suite from the view point of a consultant, a clinical director, a training programme director and a chief executive. These viewpoints determine a range of common themes which mean the duties of consultants over their career lifecycle need to be addressed; the need to expand consultant posts; and the tensions which inevitably occur. The authors believe these need to be addressed because of the need to ensure consultant roles in delivery suite are developed as a key part of seeing quality improvement.

National Health Service (NHS) Trusts are struggling to determine a long‐term strategic direction for their organizations in response to the competitive pressures generated by the NHS reforms. The development of long‐term strategic direction and the methods to implement them are presenting real challenges to the Trusts which have inherited service configurations based on bureaucratic planning frameworks rather than service configurations suited to a more competitive environment. Examines the strategic choices available to these organizations; explores the importance of identifying positive strategic choices; and discusses the advantages and disadvantages in the context of the NHS internal market.