Opinion
Mutual benefits Becoming a social enterprise means a culture change for staff, but shared ownership pays dividends, says Jan Moutrey CABINET OFFICE minister Francis Maude has said that some hospitals could be run ‘outside the public sector’, with services handed over to mutual companies owned by staff. This would be more than a cost-cutting exercise. A report from the King’s Fund found higher levels of staff engagement and, consequently, better patient care, when staff share ownership of an organisation. My employer, Spiral Health, was the first social enterprise to convert an NHS hospital into a mutual. My experience is that being freed from the red tape of the behemoth NHS has been exciting and rewarding – if, at times, daunting. At our Bispham and Rossall hospitals near Blackpool, which we run as nurse-led rehabilitation units, many of our patients are older people. We take ‘step-down’ referrals from the local acute hospital, for patients requiring a period of therapy or nursing support before returning home, and also ‘step-up’ referrals from GPs and community teams. Unknown territory The process to convert the Bispham unit to a social enterprise began soon after I arrived; the Rossall unit was added later when the acute trust awarded us a second contract. Staff were worried they were going to lose their jobs. Some staff chose to leave but the NHS contracts of those who stayed were carried over unchanged. Since no other hospital unit had converted to a mutual there was a fear of the unknown. From the outset, our managers had a clear idea of how they wanted to run the organisation. Each patient was to be treated holistically, with an equal emphasis on physical and psychological recuperation. And staff working groups were set up so that the team had the freedom to implement ideas that benefited patients and the business we all co-owned. 12 February 2015 | Volume 27 | Number 1
Since becoming a mutual we have flexed our creative muscles and implemented initiatives of which we are proud. Our approach to compassionate care focuses on understanding patients as unique individuals. Every patient has a one-page profile that tells us what is important to them and how they wish to be supported. Staff have also begun working on their own one-page profiles. We want to know what makes them tick so that we can encourage their career development. With Carers Trust Fylde Coast, previously Blackpool Carers Centre, we have recruited a team member to support families and carers. Another partnership has been formed with local universities to offer social work placements for two students who now act as a liaison point between our patients and social services. We have raised money to purchase equipment by offering single rooms as an option, although these are still allocated according to clinical need. A follow-up physiotherapy service at home for former hip and knee replacement
patients who were having to wait up to six weeks for community-based therapy has been piloted. The trial was a success and we have been commissioned to continue it for another six months. Being a mutual brings with it a sense of ownership and autonomy. Patients tell us they appreciate our friendly, homely environment. By helping them recover more quickly than they could on an acute ward we also save the NHS money – £2.7 million in 2014. For example, the average time taken to rehabilitate on an acute ward is 28 days compared with 17 days for our patients. Ninety seven per cent of our patients return to their own homes and the same percentage feel they are treated as individuals. There are challenges. As a clinical leader I have had to steer my team through a period of culture change, while learning how to cope myself. The ongoing process of re-bidding for contracts can also be unsettling. We are setting up a third intermediate care unit, this time in Preston, and our experience over the past two years is paying dividends. The mutual model has much to offer health care in my experience. Bring on the culture change and we will show you what nurses are made of. Jan Moutrey is matron, Spiral Health
Holistic approach: matron Jan Moutrey in the reminiscence room at Rossall rehabilitation unit, near Blackpool
NURSING OLDER PEOPLE
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Mutual benefits Becoming a social enterprise means a culture change for staff, but shared ownership pays dividends, says Jan Moutrey CABINET OFFICE minister Francis Maude has said that some hospitals could be run ‘outside the public sector’, with services handed over to mutual companies owned by staff. This would be more than a cost-cutting exercise. A report from the King’s Fund found higher levels of staff engagement and, consequently, better patient care, when staff share ownership of an organisation. My employer, Spiral Health, was the first social enterprise to convert an NHS hospital into a mutual. My experience is that being freed from the red tape of the behemoth NHS has been exciting and rewarding – if, at times, daunting. At our Bispham and Rossall hospitals near Blackpool, which we run as nurse-led rehabilitation units, many of our patients are older people. We take ‘step-down’ referrals from the local acute hospital, for patients requiring a period of therapy or nursing support before returning home, and also ‘step-up’ referrals from GPs and community teams. Unknown territory The process to convert the Bispham unit to a social enterprise began soon after I arrived; the Rossall unit was added later when the acute trust awarded us a second contract. Staff were worried they were going to lose their jobs. Some staff chose to leave but the NHS contracts of those who stayed were carried over unchanged. Since no other hospital unit had converted to a mutual there was a fear of the unknown. From the outset, our managers had a clear idea of how they wanted to run the organisation. Each patient was to be treated holistically, with an equal emphasis on physical and psychological recuperation. And staff working groups were set up so that the team had the freedom to implement ideas that benefited patients and the business we all co-owned. 12 February 2015 | Volume 27 | Number 1
Since becoming a mutual we have flexed our creative muscles and implemented initiatives of which we are proud. Our approach to compassionate care focuses on understanding patients as unique individuals. Every patient has a one-page profile that tells us what is important to them and how they wish to be supported. Staff have also begun working on their own one-page profiles. We want to know what makes them tick so that we can encourage their career development. With Carers Trust Fylde Coast, previously Blackpool Carers Centre, we have recruited a team member to support families and carers. Another partnership has been formed with local universities to offer social work placements for two students who now act as a liaison point between our patients and social services. We have raised money to purchase equipment by offering single rooms as an option, although these are still allocated according to clinical need. A follow-up physiotherapy service at home for former hip and knee replacement
patients who were having to wait up to six weeks for community-based therapy has been piloted. The trial was a success and we have been commissioned to continue it for another six months. Being a mutual brings with it a sense of ownership and autonomy. Patients tell us they appreciate our friendly, homely environment. By helping them recover more quickly than they could on an acute ward we also save the NHS money – £2.7 million in 2014. For example, the average time taken to rehabilitate on an acute ward is 28 days compared with 17 days for our patients. Ninety seven per cent of our patients return to their own homes and the same percentage feel they are treated as individuals. There are challenges. As a clinical leader I have had to steer my team through a period of culture change, while learning how to cope myself. The ongoing process of re-bidding for contracts can also be unsettling. We are setting up a third intermediate care unit, this time in Preston, and our experience over the past two years is paying dividends. The mutual model has much to offer health care in my experience. Bring on the culture change and we will show you what nurses are made of. Jan Moutrey is matron, Spiral Health
Holistic approach: matron Jan Moutrey in the reminiscence room at Rossall rehabilitation unit, near Blackpool
NURSING OLDER PEOPLE
Downloaded from RCNi.com by ${individualUser.displayName} on Dec 07, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
