Hospitals in a group with Maria Kane

The Group covers North Bristol Trust, University of Bristol hospital and Weston Hospital Trust. The Trusts had discussed alignment for some time as they faced fragile service arrangements, competition between the organisation for staff and capital and too much time responding to ill health rather than developing anticipatory models of care.

The collaboration started initially with a joint clincial strategy, which developed into a single accountability framework that the Trust Boards signed off in December 2023. A joint Chair and then a joint CEO followed. This approach was supported by site managing directors.

What made a difference initially ? 1) enthusiasm of clinicians 2) permissions to do things differently 3) focusing on the commonalities, not differences 4) proud organisations wanting to do things differently and developing joint digital approaches.

The Boards developed a joint approach by describing their challenges and working on joint challenges together. This always involved putting a patient first methodology and developing a common improvement language and approach. The Trusts formally evaluated the group approach judged against the outcomes they wanted to achieve.

Now the group has around 28K staff - develops work together; shares leadership approaches and have developed mature leadership teams, underpinned by a health research ethos.

The Group CEO role is different to single hospital CEO roles because Maria has to be out of the detail, delegate to her teams and focus on approaches that drive the benefit of working together. This means working through what is right for the population and is already then leading to different investment decisions. Control has to be delegated to teams and data analysis has to be enhanced to ensure the focus is on the right issues.

Maria describes how she had been used to a set of personal relationships and that underpinned how she worked effectively. Now she has to focus on maximum impacts; better use of data; work with teams across sites to make improvements; be non partisan; be an arbiter; narrate and manage relationships with external partners.

Looking to the future, Maria see the duty to collaborate and cooperate in the public realm as being crucial. Supporting a new set of senior leaders is going to be key. As a leader you must be courageous, curious and look to improve care all of the time.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Leadership & culture in healthcare

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