One group, two trusts, seven hospitals
The NHS response to Covid-19 showed we could successfully manage an unprecedented health emergency by working together across institutions. As operational and financial pressures intensify, the NHS is applying that learning to business as usual.
In north east London the engine of this post-pandemic co-operative spirit is the closer collaboration between the Barts Health group and Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT). We are working within a wider acute provider collaborative in north east London with Homerton Healthcare.
Our informal partnership has already secured some tangible benefits for patients. We have reduced waiting times for tests, prevented unnecessary hospital admissions, and improved transport to and from hospital for those who need it.
In recent weeks our collaboration secured £44m funding for BHRUT to procure an electronic patient record for the first time. When this goes live it will use the same system Barts Health and Homerton have and enable patients' health records to be viewed by NHS clinicians anywhere in north east London.
The leaders of the two trusts believe we can achieve even more for patients if we embed collaboration more broadly and deeply in the way we both work.
We want to create the conditions in which our clinicians collaborate more easily, and our hospitals routinely work together, for the benefit of our patients and their communities.
Our aim is that, wherever they live, our patients have fair access to the best possible care, through strong local hospitals with links to specialist facilities, supported by a cost-effective infrastructure offering better opportunities for our staff.
Both trusts share comparable values and a collective vision to provide the highest quality care. We have a common interest in improving services for patients and reducing health inequalities among local people. We face similar performance challenges in ever-more constrained economic circumstances.
We believe that we can deliver better results, more effectively and efficiently, by combining our resources where appropriate. This will mean:
- For our patients, more equal access to the best care, wherever they live
- For our people, more opportunities to develop meaningful careers
- For our partners, more action together to reduce health inequalities
Hence the respective boards agreed in May 2023 to formalise our collaboration by working as a group of hospitals.
This is based on the Barts Health model of localising where possible but centralising where necessary. That in turn means devolving operational responsibility to hospitals while using the group’s scale to leverage efficiencies and ensure equity.
The trusts remain separate statutory bodies accountable to NHS England and regulated by the Care Quality Commission. Over the next 18 months we will move towards having a single group executive team under Shane DeGaris operating as part of a single board across the two organisations chaired by the Rt Hon Jacqui Smith.
This builds on the appointments of the chair in common in July 2021, the group chief executive of both trusts in May 2022, and the deputy group chief executive in July 2022.
The current boards will jointly oversee an open and transparent convergence process to put these governance changes into effect and appoint to the group executive and joint non-executive director posts.
We anticipate appointing joint executive roles covering finance, strategy and planning, and group development and digital, by April 2024. We will also appoint a joint Chief Information Officer as an early priority.
The hospital CEOs (including Matthew Trainer as deputy group CEO) will be board members. The group will support them by exercising consistent strategic leadership and facilitating effective corporate services in areas like procurement, informatics, and recruitment.
Each hospital will play a key role in local place-based partnerships, with Queen’s and King George managed as a single business unit, like The Royal London and Mile End, while still within BHRUT. Over time we will refer to this model of one group, two trusts, seven hospitals by the shorthand of the Barts NHS Group.