Strategic Mindsets for NHS Foundation Trusts

I'm preparing for a workshop on Independance and Regulation in the NHS that takes place on Thursday. We need an exercise to help participants explore the strategic possibilities afforded by a hospital(s) becoming a Foundation Trust and I've just come up with this. I hope FT Boards do have explicit discussions about whether to adopt a distinct strategic mindset and if so which one. Do you think they do? Afterall, what's the point of becoming a FT otherwise?  Anyway here's the exercise. 

Strategic Freedoms Exercise

Imagine that you are a Board member of a DGH type Acute Trust that has just been granted FT status. As a Board you are keen to take advantage of the strategic freedoms being an FT affords. The only problem is the Board can’t yet agree on what, if any, guiding strategic mindset to adopt.

Currently 4 ‘mindsets’ have been proposed, at various times in the last 6 months, by different members of the board. These are shown in Figure 1 and can be summarised as:

Compete with ‘Look Alikes’

The Trust continues to seek to provide a comprehensive range of services whilst growing by winning market share from neighbouring acute trusts that are believed to be in a weaker position.

Refocus on Core Services

The Trust needs to stop pretending that it can be good at everything and re-focus on what it is good at. It needs to be single minded in seeking to earn a deserved regional reputation that leads to higher volumes of core work.

Become Entrepreneurial

The Trust needs to get off the mark quickly and enthusiastically seek out large number of opportunities for creating or contributing to new services and /or offering established services in new settings or to new groups of customers. Seeking out these opportunities will probably mean the Trust ‘reaches’ deeper into the primary care landscape. Once established, new ‘business lines’ might be retained by the Trust or sold to new market entrants.

Be a Strong LHE Partner

The Trust recognises that is has a responsibility to act in the best interests of the local health economy as a whole. Accordingly, it needs to become a more active and sensitive partner to other established organisations already operating in the LHE. The Trust needs to use it’s resources and skills to consistently seek to serve the wider good.

This is the first Board meeting since FT status was ‘won’. Triggered by the PCT announcing a comprehensive review of Paediatric services the Board quickly needs to agree on what it sees as its’ future contribution to this service area.

1. What kinds of questions and issues might each strategic mindset suggest for the Board’s consideration?
2. How might the various strategic mindsets influence the Board's view about how best to serve paediatric patients in future? 

Thanks to my friends at YCHI for helping to flush this idea out late on a Friday afternoon!

Steve

www.stevepashley.co.uk

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