Governing Hospice Projects: a review of governance, leadership, and management as seen in the foundation of the modern hospice movement

Abstract

This article reviews findings from a study of corporate vision in hospice foundation in Britain. Evidence was obtained from 77 different independent charitable hospices about their founding groups, and the projects they carried out. The identified qualities of successful corporate visions are reported. The typical hospice is a very substantial charity organisation, representing a major achievement in both fund‐raising and management terms. The groups who founded these hospices are shown to number 12 members on average, a significant difference from management groups in businesses. Groups also show striking consistencies in the professions represented, indicating a conscious and deliberate approach to recruitment. Social workers and administrators seem to have been under‐represented, leading to later weaknesses in many organisations. An informal delegation of decision‐making authority is evident, and very few decisions are recorded in committee minutes. Even fewer were division votes, which usually resulted in resignations of members. Patterns of leadership are explored, and it is shown that conventional assumptions about the need for charismatic leaders to maintain these projects are false. The leadership of these projects appears to reside in the maintenance of the original corporate vision. It is also shown that these organisations recognise authorities or influences that do not appear in their formal or legal structure, and this is a feature of institutions.