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‘More NHS organisations should become mutuals’

15 July 2014

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High levels of staff engagement improve quality of care for patients, an independent review has concluded. 

The report, released by healthcare thinktank The King’s Fund, claims that more NHS organisations should be encouraged to become staff-led mutuals. 

Organisations where staff are strongly committed to their work and involved in decision-making deliver better care report lower mortality rates and better patient experience. 

High levels of engagement also result in less staff turnover and lower staff sickness absence.

Over the past few years staff engagement levels in the NHS have been on a steady rise, however there has been significant variation between organisations, the thinktank claims. 

Making staff engagement a “key priority” could go some way towards improving care at a time of financial and service pressures, the group said. 

Evidence is emerging that by giving employees a stronger stake in their organisation, staff-led mutuals deliver higher levels of staff engagement.

Leaders and staff working for mutual organisations said they feel a strong sense of ownership and empowerment, which is leading to better organisational performance.

The review recommends greater freedom for NHS organisations – including hospitals – to become mutuals, on a voluntary basis. 

It calls on the government to launch a programme of pathfinders to enable further evidence to be gathered about the benefits of mutuals and whether they could be adopted on a larger scale across the NHS.

Chris Ham, chair of the review, said: “The evidence that more engaged staff deliver higher quality care is compelling – a simple truth that should be acted on by all NHS organisations. Increasing staff engagement is first and foremost the responsibility of NHS leaders, from the board to the ward. But it is also time to give serious consideration to the role staff-led mutuals could play in increasing staff engagement and delivering benefits to patients. 

“This should be accompanied by more proportionate regulation so that NHS organisations can look out to their patients, staff and stakeholders, rather than up to national bodies.” 

NHS Confederation chief executive Rob Webster said: “It is vital that we recognise that different organisational models will best suit different parts of the health service and different parts of the country. What is right for a major acute trust in a large city may not be the same as for a community-based service provider covering three rural counties.

“Just as we should devolve decision-making about patient care to experts at the right level in our workforce, we should resist imposing one organisational model on the health service from the centre. This is not a ‘one size fits all’ issue. Above all, we must resist a descent into discussions about organisational form, rather than grasp the nettle of service redesign for the 21st century.”