Review highlights potential bigger role for specialist trusts​

A new report outlines how high performing specialist trusts have the potential to do more to benefit the wider NHS. 

A review of around one-third of England's 21 specialist trusts looked at why they consistently score higher than their counterparts in ratings for performance and satisfaction. 

It was carried out by two leaders from the AHSN Network, who recommended seven ways in which local systems can benefit more widely from the role of specialist trusts. 

The review focussed mainly on the North West and London where there are clusters of specialist trusts, to explore the reasons for higher performance indicators – and to identify whether there is potential for them to do more. 

The report authors were Dr Liz Mear and Dr Charlie Davie.

Dr Liz Mear, Chief Executive of the Innovation Agency, the Academic Health Science Network for the North West Coast, said: "It is well known that specialist trusts enjoy consistently high ratings from CQC inspections, staff and patient surveys. 

"Within the AHSN Network we are also aware that specialist trusts tend to be more successful with innovation – supporting staff to do things differently and working with external organisations such as ourselves, businesses and charities. We were keen to find out why, hence the review."

Dr Charlie Davie, Managing Director of UCLPartners, said: "Specialist trusts are frequently seen as the 'honest broker' in their local systems and many have taken on cross-cutting leadership roles which we feel could be formalised and expanded.

"There is more that could be done by commissioners and local systems to harness the potential of specialist trusts, for instance in leading transformation programmes and also in learning from their culture and approach to innovation."

The recommendations are:

  • All trusts should establish a senior post for innovation, linking to supportive agencies such as AHSNs and NIHR

  • The AHSN Network should collaborate with specialised commissioners and the specialist trusts group to develop a best practice approach to service innovation and a supporting expert team capability accessible to all trusts

  • Specialised commissioners should consider supporting the international benchmarking of specialist trusts, using some of the service outcomes standards as part of the core specification with all providers

  • A pump-priming fund should be established by national commissioners such as NHS England, to be accessed through bids from specialist trusts and other providers, to take forward wider service advances, on the condition that they lead the roll out 

  • The proposed NHS Confederation work should explore whether the collegiate culture of specialist trusts could be replicated in other provider organisations

  • NHS England should consider how specialist hospitals could provide a supportive population health management role in STP work around the standardisation of care pathways and adoption of prevention activities

  • Every specialist hospital should establish a formalised partnership with their local AHSN to take forward service innovation and accelerate adoption and spread. 

The report was commissioned by the Federation of Specialist Hospitals and the full version is available here.