The ‘collaborative’ method, developed by the US Institute of Health Improvement, has succeeded in motivating staff and responding to patients' concerns about acute in-patient psychiatric care across 37 trusts in the Northern, Yorkshire and Trent regions. The method puts into practice the new values underpinning government policies on ‘modernising’ and ‘shifting the balance of power’ in the NHS, i.e. seeing things through the eyes of patients, empowerment of frontline staff, learning networks and focus on measured outcomes. The evaluation suggests that organisational and management culture crucially determined the level of achievement of the trusts taking part in the collaborative. Evaluations of other collaboratives have raised doubts about the sustainability of the improvements achieved. It is argued that refining the collaborative method is less important than incorporating its principles into the existing management and organisational cultures of NHS trusts, and the leadership styles of chief executives and clinical directors.
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