Welcome to the most exclusive club in the NHS

It has just 10 members, all of them leading academic hospitals with clean records and powerful chief executives, many of whom have been in office for a long time. Unsullied by the scandals that have damaged the foundation trust brand, the members of the Shelford Group see themselves as the backbone of the NHS in England: “harbours of stability” in changing times, to quote Andrew Cash, chief executive of Sheffield Teaching Hospitals NHS Foundation Trust. To anonymous critics from humbler trusts whose playground is the comments section following online articles in Health Service Journal, they are fat cats trading on past glories—a would-be premier league that sits at the top of the funding pyramid, has avoided the worst of the economies forced on others, and intends to maintain that privileged position by collective action.

I put the criticism to Robert Naylor, chief executive of University College London Hospitals NHS Foundation Trust and current chair of the Shelford Group. Are you fat cats monopolising the cream? “If we are we don’t intend to be,” he said. “We have a particular common interest as teaching hospitals and major research centres. We recognised we were in a different place to the rest of the NHS. When benchmarked against the rest of the NHS we were better than average, which is not terribly helpful as a form of benchmarking. So we decided to come together, the 10 of us, and the real purpose was to benchmark against each other.”

The prime mover was Gareth Goodier, then chief executive of Cambridge University Hospitals …