What is a typical hospital structure?

What is a typical hospital structure?

In this article we will describe what is a typical hospital structure.

People often ask ‘who runs hospitals?’ The short answer is .. we do. Doctors, nurses and managers run NHS hospitals.

They usually work within a three-tier structure:

1. Board. Chairperson and Non-Executive Directors, and Executive Directors (‘Executives’). There is usually a core group of five executives, comprising:

• • Three managers: Chief Executive Officer (CEO; most senior person or ‘Accountable Officer, AO)’, Chief Operating Officer (COO) and Chief Finance Office (CFO)
  • A doctor: Chief Medical Officer (CMO). They will be a hospital consultant. They are sometimes assisted by a ‘Chief Registrar‘, who keeps them in touch with other registrars and junior doctors
  • A nurse: Chief Nursing Officer (CNO).

2. Divisions. Examples include Medicine, Surgery, Women’s and Children’s, Urgent Care and Support (see below). There are groups of similar departments within 5-7 divisions (also called directorates or groups).

3. Departments (by division):

• • ‘Medicine’: General (e.g. Acute and Geriatric) Medicine; Specialist Medicine (e.g. Diabetes, Dermatology, Gastroenterology, Rheumatology, Neurology, Cardiology and Respiratory)
  • Surgery: General Surgery, Trauma & Orthopaedics; Specialist Surgery (e.g. Breast and Vascular)
  • Womens and Children: Obstetrics & Gynaecology, and Paediatrics
  • Urgent Care: A&E, and ICU. In some hospitals Acute Medicine may be in this division
  • Allied Health Professionals: Physiotherapy, Occupational Therapy, Dietetics and Speech and Language Therapy (SALT)
  • Support: Outpatients, Operating Theatres, Infection Control, Pharmacy, Radiology and Pathology.

Leading each Division and Department, is a triad of a senior doctor, nurse and manager. The doctor is usually the ‘head of department’ or ‘head of division’. Though all these roles have a variety of titles.

The larger regional ‘teaching hospitals’ may have extra specialised departments like renal medicine/transplantation, plastic surgery etc. And they may have extra departments like Research and Development, and Innovation.

There are other (non-clinical) services that work across the hospital in all departments, e.g. IT, estates, domestic/catering, portering etc (these may be NHS or private sector).

Summary

We have described what is a typical hospital structure. Please get involved in the organisation of your hospital. There is a role for all. Your skills and experience will really help.