Sir William Wells' Review of the NHSU

This report was commissioned in 2004 into the NHSU and has never been released to the public. Following a landmark victory with the Information Tribunal by Rod Ward, this report has now been made available. We are indebted to Rod Ward for making this report available and his summary of the report is as follows:

"The NHS university was proposed in the labour manifesto of 2001 and established as a special health authority in 2003. It's demise was announced on November 30th 2004 by the then Health Secretary John Reid, following a report into it's progress and performance by Sir William Wells. The report itself is in two parts, the first detailing progress and performance and the second forward to the creation of the "NHS Institute of Healthcae Innovation and Education". It starts by setting out the original concept behind the NHSu, but even on page one criticises the lack of clarity about where the NHSu fitted into the "already crowded healthcare education and training sector" and what its role should be. It goes on to describe tensions between strategic objectives and potential roles as a provider or broker of training. The lack of understanding of the wishes of customers (eg Strategic health Authorities) , is highlighted as a reason for the lack of support and integration with the wider NHS. The quest for University title is highlighted as a major problem which was not understood by senior staff in the NHSu or ministers and added to confusion over the NHSu's role.

A major part of the report is devoted to delivery and value for money, which deals with a range of issues including; the staff complement of 412, learning services, and academic partners. It gives some numbers of the limited take up of NHSu courses ad predicts that these would not meet the projections, particularly once the courses had to be paid for. Comments from a variety of stakeholders about the lack of a clear business plan caused Sir William concern as did the processes for governance. The 30% of staff involved in corporate services "seems disproportionately large" especially when viewed in the light of comments about the "culture and style of a start-up enterprise" and the lack of focus on structure and systems. Frequent changes of structure and individual roles were seen as another barrier to the establishment of effective working.

The report concludes with some answers to crucial questions about whether the investment was appropriate and over what timescale it is likely to bear fruit. The answers are damming and relate to lack of clarity of purpose, the absence of market surveys or prices, governance, pursuit of the University title, and engagement with stakeholders. It suggests that in the light of the £72 million investment up to March 2005 "the Department of Health is exposed to significant embarrassment if the value for money delivered by the NHSU were to be probed"."

The report can be downloaded here (registered members only)

"Safety First" report says that national patient safety systems are not improving safety

This report was commissioned by Sir Liam Donaldson, Chief Medical Officer, to reconsider the organisation arrangements currently in place to ensure that patient safety is at the heart of the healthcare agenda. The review explicitly aimed to address issues raised by the National Audit Office in its report, A Safer Place for Patients, as well as to look at the NHS approach to patient safety more widely. The report makes a number of key recommendations to build on the progress already achieved in embedding patient safety in the NHS. These include establishing a national patient safety forum to oversee the design and implementation of a national patient safety initiative; simplifying the reporting of adverse effects to make it easier for clinical staff to report on a confidential basis without the fear of retribution; and establishing Patient Safety Action Teams to support frontline staff in delivering the national patient safety agenda. To access the report, click here

Handling concerns about the performance of healthcare professionals: principles of good practice

This best practice guidance has been developed by the Department of Health on handling concerns about professional practice has been developed collaboratively by senior individuals of all healthcare professions, regulators, commissioners and patient groups. It may be useful in all settings where healthcare is offered and encompasses everyone whatever their position in the organisation. To find out more, click here

The true cost of NHS Management Consultancy

The imposition of turnaround teams on cash-strapped trusts has cost the NHS more than £22m, new figures reveal. Three of the trusts with the worst financial problems have each paid out over £1m to finance the management consultants. Surrey and Sussex Healthcare trust came out on top with a £1.5m bill. The Department of Health contributed just £93,000 towards the costs. The £21.1m turnaround bill comprises only 97 trusts and PCTs. Since the figures were compiled for MPs in May, the number of turnaround teams has risen to 143. Turnaround trusts have had to fund their own support; the DoH only contributed £93,000 towards the first three months of the 23 turnaround trusts with the deepest problems. To find out more, click here

Fit to lead: a review of the Primary Care Trust Professional Executive Commitee

"Fit to lead: a review of the Primary Care Trust Professional Executive Commitee" has been published by the Department of Health and is a consultation document on the future of PCT's committee. It includes proposals to reduce the number of Executive Committee members and remove the need for a nurse on the Committee. To find out more, please click here

Who Cares Wins - the business aspects of patients care

Who Cares, Wins is a study commissioned by The Burdett Trust for Nursing about the business aspects of patient care and the implications for nurse leaders and their boards. Designed to trigger the actions that will take patient care ‘from bedside to the boardroom’, the report argues that if a more market driven health system is going to deliver ‘a new NHS’, then patient satisfaction and customer care need equal ranking with finance, targets and outputs on board agendas. The business of caring is a whole board issue. Nurse leaders, because they have or can develop many of the qualities that will be required to deliver on this agenda, and as a result of the increasing breadth of their responsibilities, are well placed to lead the business of caring on their board’s behalf. There are examples of exceptional clinical leaders who have succeeded in making patient care a driving force in their organisation’s strategy and operational processes, but they are in short supply. This can be accessed here (registered users only)

An exploratory study of the clinical content of NHS trust board meeting in an attempt to identify good practice

This exploratory study, commissioned by The Burdett Trust for Nursing and conducted by the University of Plymouth, studied the clinical content of NHS Trust meetings in an attempt to identify good practice. We examined publicly available board meeting minutes for a random sample of 60 Trusts. We identifi ed trusts with higher and lower levels of clinical content and examined the minutes of a sub-sample over one year to check consistency. Minutes for two trusts with high clinical content were reviewed in more detail to identify possible factors leading to greater focus on clinical matters. Based on these reviews a checklist approach was used to review factors in low scoring trusts.

The study looked at practice in a random sample of 60 trusts and found that:

• Overall just 14% of items in trust board meetings were rated as clinical but varied between 7% and 22% over the year for different Trusts.
• Trusts with higher levels of reporting of clinical issues seemed to have a chief executive who ensured that clinical issues were closely linked to all Trust developments including finance and information technology.
• In trusts with higher levels of clinical content, non-executive directors seemed to question and interrogate trust board executives in an open and transparent manner.

This can be accessed here (registered users only)

Review of the literature on team leadership published

We have published our "Review of the Literature on Team Leadership" which was commissioned by the Health Foundation. The review contains an analysis of the key literature on teams, team development and team leadership. It also provides an evidence base to a variety of team interventions and should be of particular use to those who are trying to develop team leadership prorgammes. This can be accessed here (registered users only)

The Performance and Innovation Unit Review on Leadership Literature

The Performance and Innovation Unit (part of the Cabinet Office) produced this literature review which is an excellent analysis of changes and trends in leadership thinking and the implications for public sector leadership. The review is Annex D of "Strengthening Leadership in the Public Sector" by the PIU (March 2001) - Performance and Innovation Unit. accessed here (registered users only)

Warwick University's Systematic Review of the Leadership Development literature

The field of leadership development has generated a growing body of literature. This study, which looked at about 3,500 items, mainly from the USA, Canada, Australasia and the UK, aimed to find and assess the most valuable contributions. This can be accessed here (registered users only)

Henley Management College's literature review

"A Literature Review: Evidence of the contribution leadership development for professional groups makes in driving their organisations forward" by Sadie Williams of Henley Management College, Greenlands, Henley-on-Thames. The aim of the review was to answer the question, what evidence is there of the contribution leadership development of professional groups makes in driving their organisations forward? This can be accessed here (registered users only)

QNI Social Enterprise Briefing

The Queens Nursing Institute has just published a briefing guide to Social Enterprises which can be accessed here There is also an excellent collection of resources on the Social Enterprise page of the NHS Networks site

Budgeting for change - a practical budgeting workbook

This is a workbook designed to help nurses understand and manage budgets. The guide is divided into nine sections and gives practical help to ward managers in managing and setting budgets. The workbook can be accessed here (registered users only)

10 High Impact Changes

The NHS Modernisation Agency, through its work with thousands of NHS clinical teams, has identified ten high impact changes that organisations in health and social care can adopt to make significant, measurable improvements in the way they deliver care. These can be accessed here.

A pilot study to assess the case for e-learning in the NHS by David Dawes and Ali Handscomb

This is the largest published e-learning study of nurses with a sample of 400 learners studied over three months. This.can be accessed here (registered users only)

“When you wish upon a star – the lack of impact of Chief Executives on their Trust’s star rating” by David Dawes

This study aims to identify the contribution of the Chief Executive to the change in their Trusts’ performance rating from 2000/01 to 2001/02. It involved an analysis of the Trusts whose performance could be directly compared in the two years, and of the characteristics of the organisation’s Chief Executive. This.can be accessed here (registered users only)

Nurses on Board - An analysis of nursing leadership in first and second wave PCTs by David Dawes and Karen Dobson.

This audit was carried out by the National Nursing Leadership Project in order to better understand the development of nursing leadership in the first and second wave Primary Care Trusts (PCTs). This.can be accessed here (registered users only)

Primary Care Trusts - Two Years On by David Dawes.

This article analyses nurse leadership and PCTs at the end of the 4th wave of PCTs and revisits some of the findings in "Nurses on Board", which was the first comprehensive study of the role of Board and Executive nurses in the first two waves of PCTs. This can be accessed here (registered users only)

Getting on against the odds - developing black and minority ethnic nurse leadership

Getting on Against the Odds is a practical learning resource aimed at managers and clinical professionals. It supports the development of nurses, midwives and health visitors from black and ethnic communities and features the triumphs, successes and struggles of black and ethnic nurses, midwives and health visitors. It offers solutions, options and a way forward. This can be accessed here