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'To strengthen and cultivate evidence based practice in health care and at the interface of health and social care'

Page updated: 1 May 2003

Evaluation of shared governance within an integrated NHS trust

Whilst well established in America and Canada, shared governance is a relatively new concept in British health care organisations. Shared governance has been described as a system of management that promotes the empowerment of nurses by moving away from the traditional, hierarchical style of nurse management. Having assumed control over their own clinical and professional development under a shared governance framework, the healthcare professional then has the responsibility and authority to implement change and contribute to the wider corporate agenda.

Rochdale NHS Trust (now Pennine Acute Hospitals NHS Trust) adopted a councilor model of shared governance 4 years ago. Within the wider context of an evaluation of the Trust model, the PhD study focused on the strengthening of staff decision making within the councils that comprised representatives from across the healthcare professions. Its specific objectives were:

To identify key factors that affect shared governance decision making
To utilise an action research approach to strengthen shared governance decision making so promoting the effectiveness of the model

An empowering action research approach was used successfully to enable the consideration of ongoing findings to guide the development of the shared governance initiative. The study took an ethnographic form, utilising data collection methods of participant-observation, in-depth interviews and focus groups. The findings have culminated in development of a conceptual model. In summary this proposes that effective shared governance decision making will be promoted if council members do the following:

Clarify what the issue/problem is
Establish whether it fits their council remit
Appraise whether the size (scale, time required etc) is manageable
Establish a clear aim
Identify a lead to co-ordinate/drive it
Establish a level of authority
Collate appropriate background information
Identify a key informant/s with relevant subject knowledge

Additionally, effective decision making processes will be promoted by having present:

Some mechanism for evaluation/feedback/refinement
Adequate skills amongst members
Sustained provision of support/guidance
Sufficient/appropriate membership to undertake the decision making

For further details, contact:
Tracey Williamson, Research Fellow
Health Care Practice Research and Development Unit (HCPRDU)
University of Salford, Statham Building, Statham Street
Salford M5 4WT
Tel: +44 (0) 161 295 2824 Fax: +44 (0) 161 295 2825
Email: tkwrgn@aol.com
© HCPRDU, University of Salford, 2003