Commercial Awareness in the NHS
The context of this study is a large National Health Service (NHS) Community Provider within the
North West operating within a market driven environment. The aim is to explore what ‘being commercial’ means to the organisation. Whilst literature exists on what commercial means within a conventional business environment little has been written on how this translates to the unique business of the NHS. The principles of grounded theory will be used for this research which allows
“…a theoretical lens that shapes the study” (Creswell, 2007, p.42). Initially a purposive sample will be drawn from the organisation’s Executive Team, as it is believed that they have valuable knowledge pertaining to this research due to their professions and experience (Bowling, 2002). A fundamental approach to grounded theory is that the emerging themes from the initial sample will determine who to talk to next (Glaser, 1992). It is expected that common and consistent themes of what ‘being commercial’ mean to the Executive Team will emerge allowing the development of a consistent approach being adopted across the organisation.
Liverpool Community Health NHS Trust (LCH) is the largest community provider in
Merseyside, delivering preventative care, diagnostics, treatments and healthcare for
Liverpool, Sefton and surrounding areas. Recent structural changes have seen a split of commissioning and provider functions across NHS organisations. To further legitimise this all NHS provider functions have had to be reconstituted into standalone autonomous organisations. This has required all NHS providers to undergo assessment to evidence their eligibility to achieve Foundation Trust Status. For those unsuccessful in achieving Foundation Trust Status will and has resulted in them merging or being acquired by other NHS provider organisations. The rational for creating Foundation Trusts is to enable NHS organisations to operate within a new commercially driven market. At the time of writing LCH is undergoing assessment and needs to evidence their eligibility to become a Foundation Trust. To enable LCH to operate in this competitive market will require them to be more commercial. This challenge cannot be underestimated when one considers that the majority of staff have never been exposed to operating within a competitive business environment.
As is the nature of NHS organisations, the majority of Senior Leaders have risen from clinical positions. As a Divisional Business Development Manager I believe that there are tensions across the organisation in respect to our approach to how we respond to this emerging market environment. This is evidenced by recent loss of business to other providers as a result of both capacity and capability during tendering exercises. This is further reinforced when one attempts to understand
LCH’s commercial approach and whether to harvest, penetrate, disinvest or diversify the market in which we operate.
The topic of commercialism within the NHS has been relatively ignored in literature or at best been given superficial attention. No clear explanation exists of what ‘being commercial’ means to NHS organisations. As a Divisional Business Development
Manager within LCH, I believe that to survive in this new competitive market LCH needs to have a clear vision of what ‘being commercial’ means to them. Therefore this study aims to explore this statement by undertaking a grounded theory approach in an attempt to develop a common and consistent understanding of what ‘being commercial’ means to LCH.
Conduct unstructured interviews with the 5 members of LCH’s Executive Team to explore what ‘being commercial’ means to them. Dependent upon the ‘emerging themes’ of the initial sample, data collection will be extended from other