Moving to Trust Status: The Experiences of Staff of Occupational Therapy Departments

Abstract

There has been much discussion of the NHS and Community Care Act 1990 and the changes it has brought to the delivery of health and social care. The introduction of self-governing trust status for hospitals as part of an internal market for the NHS has played a significant role both in the lives of occupational therapy staff and in the services that they provide. This article describes a qualitative research study into how occupational therapy staff (n=15) from both a trust and a non-trust unit have perceived and experienced these developments. The findings are considered under four key themes: the need to justify and market the role of occupational therapy; how trust status has affected staffs roles and relationships; how staff understood trust status to have affected the departmental identity, and concepts of leadership, power and autonomy; and in what ways trust status has shaped staff attitudes and opinions. The findings highlight the important role played by departmental leadership during moves to trust status and the interest now shown in measures of outcome to demonstrate the effectiveness of interventions. A range of perspectives on trust status is then discussed.