CSH Surrey

CSH - IRS (medium)               CSH image - child health clinic (medium)

CSH Surrey

CSH Surrey is an award winning community services provider with a passion for quality and innovation. They provide community health services for adults, children and their families, in the homes, schools, clinics or community hospitals of mid Surrey.

Why they developed?

CSH Surrey’s managing directors, Jo Pritchard (nurse and health visitor) and Tricia McGregor (speech and language therapist), set up what was then known as Central Surrey Health back in 2006 when they were asked by the Chief Executive of the then PCT to come up with a new and better way of delivering community services in mid Surrey. Jo and Tricia were clear they wanted three things from their new model:

  1. A healthcare organisation that was led by clinicians not business managers
  2. They wanted CSH to be employee-owned because this creates higher staff engagement and ultimately higher quality services (their model is similar to the John Lewis Partnership, although CSH co-owners do not receive dividends)
  3. They wanted CSH to be a social enterprise – so a business that has a social ethos and purpose rather than existing purely to make profit for shareholders. When they set up, they repeatedly took views from across the workforce about whether individuals wanted to make personal profit from CSH – the firm answer was always ‘no’. They chose instead to invest profits back into improving and expanding their healthcare services so more people can benefit from CSH services. They also allocate surplus into their Community Fund, which awards grants to community groups to support health and wellbeing.

In 2006, after 18 months of research, Jo and Tricia launched their pioneering co-owned social enterprise, and together with more than 650 nurses and therapists, became the first group in the country to spin out of the NHS as they believed they could deliver higher quality healthcare independently

The government’s subsequent Mutuals Policy is partly based on CSH’s experience and the quality and performance improvements they have been able to make through their model.

After being successfully operational for seven years as Central Health Surrey, they rebranded as CSH Surrey in 2013 as part of their strategy to grow and diversify.

What they do?

Their health professionals provide a wide range of inpatient and outpatient nursing and therapy services for adults: from End of Life Care to Domiciliary Physiotherapy; from Podiatry to a Rapid Response Team.

They support the health, development and wellbeing of children and young people aged 0-19 years, and their families: from Child Health Clinics to Speech and Language Therapy; from Immunisations and Breast Feeding Support Services. Furthermore, they provide specialist therapy support for children with additional needs.

Their vision is to be ‘recognised nationally for transforming health and care through pioneering, innovative and integrated services that deliver exceptional care for patients and customers’. They do this by putting patient care at the heart of everything they do, listening and responding to patients, co-owners and customers, continually improving their services, working collaboratively with partners and building on their strong co-ownership culture.

Business Structure and Partners

CSH Surrey’s unique co-ownership model has delivered higher levels of engagement, motivation, productivity and loyalty than other business models. Its annual co-owner survey results outstrip its NHS counterparts in almost every aspect, from ethos to effort. Through its co-ownership model, CSH Surrey is able to deliver higher quality healthcare through highly engaged employees who are more motivated to lead the way and continually improve services.

CSH Surrey is owned by its employees, who are called ‘co-owners’, in a model similar to the John Lewis Partnership (except CSH Surrey’s co-owners don’t benefit from dividends). Its co-ownership model has a legal and a cultural basis, and is written into CSH Surrey’s Articles of Association. CSH Surrey was the first co-owned co-owned organisation of its kind to be created out of the NHS in 2006.

CSH Surrey’s shares are held by four co-owner Guardian Shareholders, whose primary roles are to vote on behalf of their fellow co-owners at Annual General Meetings. They are accountable to CSH Surrey’s Guardian Trust, a group of six Trustee Directors who ensure the Guardian Shareholders act in the best interests of patients, co-owners and CSH Surrey.

CSH Surrey’s experience has influenced Government thinking around the delivery of public sector services. In 2011 CSH Surrey’s Managing Director Jo Pritchard was invited to join the Government’s Mutuals Taskforce to help develop its mutuals policy. Since then, thousands of public sector workers have chosen to follow CSH Surrey’s example, setting up their own, independently owned mutuals.

CSH Surrey is a member of the Employee Ownership Association.

Community Benefits

  • CSH Surrey has a Community Fund that have awarded grants of more than £18,000 to local groups to support health and wellbeing projects that benefit local communities
  • Achieved an average Friends and Family Test (FFT) score of 90 (out of a maximum of 100 and a minimum of -100) across their inpatient services and the Community Assessment Unit during 2014 (this nationally mandated question asks patients how likely they are to recommend the healthcare services to friends and family)
  • 87% patients answered agree/strongly agree to survey satisfaction statements in 2014
  • Enabled an average of 85% of patients known to us to die at home, significantly higher than the 67% national target
  • During 2013/2014, CSH Surrey reduced pressure ulcer rates to better than the national average through a focused campaign that increased awareness and knowledge among co-owners and patients/carers
  • In 2014 CSH Surrey was awarded the contract by NHS England to set up and deliver the Family Nurse Partnership programme across Surrey to better support vulnerable, first time, teenage mothers and thus improve the health outcomes and life chances for the teenagers and their babies
  • CSH Surrey is committed to supporting personal development, hosting 120 students during 2014 and supporting 20 of these through MSc and Degrees. They also supported 40 people through work experience placements
  • 98% of new joiners said they were made to feel welcome and 87% say working at CSH Surrey has lived up to their expectations (2013 CSH Surrey co-owner survey)
  • 95% of co-owners say their manager is supportive if they have a problem, compared with just 69% in NHS Community Trusts (2013 CSH Surrey and NHS surveys)
  • 96% of co-owners say their immediate manager considers their ideas and suggestions, compared with 76% in NHS Community Trusts (2013 CSH Surrey and NHS surveys)
  • 70% of co-owners feel CSH is concerned about their health and wellbeing, compared with just 46% of NHS staff (2013 CSH Surrey and NHS staff surveys)

Benefits to partners

  • Following feedback from local GPs, in 2012 CSH Surrey launched a centralized Referrals Management Centre so referrers had just one point of access to their services. This improved the quality of referrals, reduced wasted time and ultimately benefitted patients through a more seamless and coordinated experience. To date in 2014 it has handled more than 67,000 referrals, up 3.2% on 2013
  • In 2012 local GPs became the first in the country to benefit from being able to receive clinical communication from CSH Surrey direct into their own electronic systems. This has reduced costs and saved significant admin and clinical time that used to be spent scanning letters and reports to patient records, as well as improved communication between primary care and CSH Surrey.
  • CSH Surrey is integrating children’s nursing and therapy services through a ground-breaking ‘team around the family’ approach – based on listening and responding to parents’ needs and experiences. GPs and families are starting to benefit from a single point of access for referrals, multi-disciplinary assessments and interventions, as well as more timely and better supported discharges. This model will be rolled out across children’s services during 2014/15.
  • Quote from GP about palliative care at NEECH “Nothing was too much trouble (on the ward) and everybody was willing to go the extra mile, unasked. This was an excellent example of how the NHS could and should be.”


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