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NHS Mutualisation in Integrated Healthcare

  • Research type

    Research Study

  • Full title

    NHS Service Transformation: Utilising Mutuality to Develop New Models of Integrated Healthcare



  • Contact name

    Heather House

  • Contact email

  • Sponsor organisation

    University of Oxford

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Successive governments have introduced a number of structural reforms, influenced by market-based principles, to address efficiency and quality challenges in the NHS. The national political debate on the NHS has focused primarily on private versus public models of delivery, but more recently there have been experiments with mixed models. Mutualisation is seen as a promising middle ground, with a growing number of mutuals emerging in the public sector. There are now plans to utilise Mutuality in the NHS to achieve integrated healthcare: the Cabinet Office is supporting seven Pathfinder NHS Trusts who are exploring moving to a mutual model, and NHS England is supporting 29 Vanguard NHS Trusts in creating new models of integrated healthcare, some of which will draw upon the values and principles of Mutuality.
    Our proposed research will investigate, from a practical and theoretical perspective, the motivations and challenges involved in migrating to such models. We will utilise action learning and participatory change methodologies which have the dual benefit of new knowledge development and high organisational impact. We will work with the Trusts in creating, piloting, disseminating and evaluating new strategies and practices based on Mutuality. We have secured access to 6 NHS Trusts – Cheshire & Wirral Partnership, Dudley CCG, Oxleas Foundation Trust, Surrey & Sussex Trust, Tameside Hospital, and University of Leicester Hospitals. The research will examine mutualisation processes from inception and the creation of new operating models of care, through to transition to new governance and management models. Our research will lead to invaluable insights for other NHS Trusts searching for effective integrated healthcare models.
    This proposed 10 months John Fell-funded study will lead to tangible benefits for the 6 Trusts involved, result in a minimum of two journal papers, and provide the basis for a strong application to the NIHR to the value of £750,000. Outcomes of interest will be core NHS challenges: care quality, service efficiency, and staff engagement. A vital feature will be the creation of an NHS Trust network of innovation based at the Said Business School or Green Templeton College, Oxford.

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