Clinical leadership and the changing governance of public hospitals: Implications for patient experience

A growing evidence base suggests that increasing the involvement of clinical professionals on governing boards of hospitals has a positive impact on organizational performance. However, less is known about the wider conditions that influence this process and whether recent moves to restructure the governance of public hospitals, extending their formal autonomy, has made any difference to the outcome of clinical involvement on patient experience. Using four years of data and concentrating on the acute hospital sector in the English National Health Service, this study shows that clinical participation on hospital governing boards can significantly improve the patient experience of the care provided. Yet, whereas a more autonomous organizational form (Foundation Trust status) does not seem to produce positive effects on its own, patient experience appears to markedly improve in those organizations that have both higher levels of clinical involvement in their strategic apex and greater flexibility in decision-making.