Memorandum by Dr Pauline Allen (FTM 01)
RESEARCH FOR NIHR SDO R&D PROGRAMME ON
FOUNDATION TRUSTS
The London School of Hygiene & Tropical
Medicine (in partnership with Leeds University and York University)
has been funded by the NIHR Service Delivery & Organisation
R&D programme to carry out a research project. The research
is about Foundation Trusts, which are a new form of NHS healthcare
organisation.
The aim of the project is to investigate how
NHS Foundation Trusts (FTs) function, and what difference it makes
that they have new ways of being governed, both in terms of their
internal structures (as they have members and governors) and how
they are regulated from outside. We are interested to find out
the degree to which decision making has been devolved to FTs,
whether FTs are able to be more responsive to local needs and
how FTs work with other local health and social care organisations.
We plan to identify the lessons learnt from looking at FTs and
suggest how these might be used to improve the governance of all
NHS trusts (whether FTs or not).
We plan to study four FTs to understand the
effect of the new governance regime. Two will be in the London
and home counties area, and two in northern England. The burden
on the FTs we study will not be great. Over a period of two years,
we will come to the hospital on a small number of occasions to
interview a small number of senior managerial and professional
staff, and also to hold two focus groups with patients. We plan
to use two specialties as examples of how FT status is affecting
the delivery of care and patients' relationships with the hospital:
these are orthopaedics and diabetes.
The insights we derive from in-depth investigation
in each case study FT will be explored and triangulated using
the York database. The team has access to this large database
held at the Centre for Health Economics, University of York. The
database consists of English hospital-level data for all acute
and specialist hospitals. There are approximately 400 variables
that measure such things as expenditure and income, activity and
capacity, patient characteristics, speciality and staffing details,
organisational culture, and dimensions of access, quality and
performance. The data are derived from a variety of sources including:
CIPFA, NHS Information Authority, Healthcare Commission, Hospital
Episode Statistics, Department of Health websites, Dr Foster Good
Hospital guide, Monitor and specific data that has been collected
through CHE's research projects. The data cover non FTs and FTs.
The research team is experienced in studying
NHS organisations and their relationships with other care providers.
Previous studies resulted in several publications and important
lessons, and did not have negative consequences for the organisations
involved. We were careful to preserve their anonymity and to respect
the confidentiality of sensitive information communicated to us.
Similar assurances of anonymity and confidentiality will be given
to participants in this study.
RESEARCH TEAM
LSHTM: Dr Pauline Allen, Mr Andrew Hutchings, Dr
Stuart Anderson, Dr John Wright
Leeds: Professor Justin Keen, Professor Peter Vincent-Jones,
Ms Jean Townsend, Dr Paul Dempster
York: Dr Andrew Street and Professor Maria Goddard
June 2008
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