Run hospitals like Tesco stores

David Dalton is CEO of Salford Royal NHS foundation trust, the first to be rated as ‘outstanding’ by the CQC (Care Quality Commission) on two consecutive occasions, so his words carry considerable weight

He has just posted an article in the Thunderer column of The Times which is a cause for alarm to many


  • Because it drips with practical common sense ways to run the NHS more efficiently and more effectively – to end mediocrity and waste
  • Because it offers to do much more with tax-payers’ money – and to improve customer service for patients everywhere, regardless of post-code
  • Because his ideas are clearly not being listened to by those sat in NHS HQ – hence his decision to shout them loud using the Thunderer channel

Essentially, he says:

  • There are too many separate hospital trusts – England alone has 135 separate acute trusts, each with their own separate boards determining their own ways of doing things – so standards in care vary dramatically between them
  • A ‘new model’ is needed to lift and shift best practice from one trust to another – better run trusts should take over and run trusts in trouble
  • In 2016, Salford Royal moved this way and formed the Northern Care Alliance (NCA) NHS Group (aka an NHS chain) to run four other local trusts, caring for more than a million people:
    • The group has a standard operating model that ensures each hospital focuses on the right priorities using methods proven to work
    • The other four trusts were rated ‘inadequate’ when Salford took them over – now 70% of their services are already rated ‘good’ or ‘outstanding’
  • Too much variation in health services is tolerated currently
  • And huge sums are spent on management consultants and ‘turnaround directors’ in failing trusts
  • Instead, trusts in difficulties should be encouraged (why not told?) to join a chain so they can learn and implement best practice

Dalton compares such chains with Tesco and Sainsbury’s who employ a standard model per supermarket to drive up quality and increase efficiency at the same time as giving people the local shops they want

In Salford, community services, social care and even some GP practices have all become part of a single organisation – and they’ve demonstrated it works well for all interested parties

So how is it ministers and NHS leaders keep banging on about the need for integrated care, and the need for all in the NHS to be aware of and implement best practice, yet leaders on the front line feel the need to voice ways of doing this in the national media?

And given dissemination of public sector best practice information is not a commercial secret, as in the private sector, where are the national initiatives to spread them into all corners of the NHS – and what savings are being targetted?

At present, all we hear about is NHS HQ executives asking HMG for billions more of tax-payers’ money, otherwise they will never meet ever-increasing demand (ano Project Fear) – yet practical solutions, requiring no extra money, may be staring them in the face (if they read The Times)



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