The role of hospital chains in the future NHS

Against a challenging financial outlook for NHS providers, momentum has been building for transformational change to the NHS and its organisational forms.  Hospital chains, mooted as an innovative, credible and collaborative model of healthcare delivery, are receiving increasing attention.  So, what are hospital chains and what is their potential role in the NHS?

‘Chains’ is often used as a catch-all term but should not be confused with other models of care delivery involving multiple organisations e.g. accountable clinical networks, multi-site specialty franchises.  Characteristics that describe a ‘hospital chain’ include:

  • A group of hospitals operating under the same centralised strategic leadership;
  • All sites in the chain are managed for the group by devolved management teams that have delegated decision-making responsibilities for their own hospital(s) within the chain;
  • Each hospital operates within the parameters set by the overarching chain leadership;
  • Distinguishing features may include: group headquarters; standardised governance, protocols and procedures; and centralised back-office functions (e.g. HR, Finance, Procurement, Legal, Media, Communications and PR);
  • A chain could be publicly or privately owned.

The key features of hospital chains include strategic leadership, economies of scale, efficiency and a shared and cooperative culture.  These are the foundations for driving improved quality outcomes and addressing operational and financial sustainability issues.

A PwC team visited a hospital chain in Germany to find out more about the model.  To fully capture what we took away from our visit to Germany, we have put together an interactive guide to hospital chains. This covers:

  • where the model has come from and how a hospital chains narrative has developed within policy discourse;
  • the German experience to date and its relevance for the NHS;
  • the key features and findings of an effective hospital chain (leadership, scale, efficiency and culture); and
  • a call to action for the key players within UK health system (the Department of Health, NHS England, Trusts and Foundation Trusts), if they are to successfully adopt the hospital chain model.

Contact us

Ian Baxter

Partner, Corporate Finance, PwC United Kingdom

Tel: +44 (0) 7710 397 745

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