5 November 2018

Understanding the performance and potential of specialist trusts

Dr Charlie Davie and Dr Liz Mear

Many of England’s 21 specialist trusts have created international reputations for academic and clinical excellence. They also score higher than other trusts in ratings for performance and patient satisfaction.

This report, commissioned by the Federation of Specialist Hospitals, outlines how high-performing specialist trusts have the potential to do more to benefit the wider NHS.

The review recommends seven ways in which local systems can benefit more widely from the role of specialist trusts.

  • All trusts should consider establishing a senior leader for innovation, linking to supportive agencies such as Academic Health Science Networks (AHSNs) and National Institute for Health Research (NIHR).
  • Guidance on a best practice approach to service innovation should be developed by the AHSN Network in collaboration with specialised commissioners, with expert advice available to all trusts to help them fast-track service innovations.
  • Specialised commissioners should consider supporting the international benchmarking of specialist trusts, using some of the service outcome standards as part of the core specification with all providers. This will support truly world-class service delivery standards across England.
  • To help promote innovative treatments, 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 of the service innovation.
  • As the narrower range of conditions managed by most specialist trusts has allowed a more collegiate culture, trusts are asked to explore whether it is possible to replicate this within clinical units.
  • NHS England should consider how more specialist hospitals could provide a supportive population health management role in system transformation
  • As many specialist hospitals are often unaware of the national policies, levers and funding streams that might encourage faster adoption and spread of innovations, they should establish a formalised partnership with their local AHSN to take forward service innovations and accelerate adoption and spread throughout the system.