PERFORMANCE MANAGEMENT APPROACH

Performance Management Approach To Manage Corporate Risk

Performance Management Approach To Manage Corporate Risk

Organization being Part of Foundation Trust in NHS

An NHS foundation trust is an NHS trust that is part of the National Health Service in England and has gained a degree of independence from the Department of Health and local NHS strategic health authority.

They have a significant amount of managerial and financial freedom when compared to NHS hospital trusts. The introduction of NHS foundation trusts represented a change in the history of the National Health Service and the way in which hospital services are managed and provided. (Business Wire 2008)

This form of NHS trust is an important part of the UK Government's programme to create a "patient-led" NHS. Whilst their stated purpose is to devolve decision-making from a centralised NHS to local communities in an effort to be more responsive to their needs and wishes, others however see the change towards semi-independent hospital boards as a move towards privatisation of the health service.

Foundation Trusts are considered mutual structures akin to co-operatives, where local people, patients and staff can become members and governors and hold the Trust to account. For example, Blackpool Fylde and Wyre Hospitals NHS Foundation Trust has 31 Governors, made up of Appointed, Public and Staff Governors who act as a key link between patients and the public and the Board of Directors. Some trusts are more committed to co-operative principles and have even written the Rochdale Principles into their constitution and aspire to work closely and in partnership with other mutual as well as local organisations. (Chen 2007 69)

A clear theme emerging from our research was that hard information, used in isolation, is seen as an inadequate and sometimes misleading indicator of NHS Trust performance. Regional office staff examine closely the hard financial information from Trusts in order to assess whether Trusts are meeting their targets. However, this information is not used in isolation of the knowledge of other factors affecting the Trust and this was reflected in the choice of Trusts they put forward. Those characterised as being at the lower end of performance were not necessarily the ones which on paper had the worst financial performance and vice versa. Aside from obvious special factors (e.g. the Trust was removing spare capacity or was due to merge), the main factor which tempers the views on financial stability of Trusts is the degree to which the Trust acknowledges the fact that a problem exists and takes action to deal with it. Regional office staff will judge more harshly those which ignore or try to hide their financial situation, even if they have a less severe problem (in terms of size of deficit) than another Trust which openly acknowledges the issue:

“It is almost a bigger crime to have not said anything than to have had something go wrong. So if [the Trust] has a deficit we are all bothered about it but what would be ten times worse would be to get to ...