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Organisational structure

The Trust Board is responsible for the running and management of the Trust. It is made up of directors, including the Chief Executive, who are full time senior staff, plus an independent lay Chairman and Non-Executive Directors who hold part time positions.

The Directors bring expertise from their positions in key areas of the Trust, while the Chair and Non-Executive Directors offer their skills and experience from a wide variety of roles in the community.
More information about the Board of Directors

The Trust is organised into five clinical divisions - Women's and Children's Services, Medicine, Surgery Head and Neck, Specialised Services and Diagnostics and Therapies - and a sixth division, Trust Services, which consists of all corporate services including Facilities and Estates, Information Management and Technology and the Trust headquarters function. Each clinical division is led by a Clinical Chair, appointed on a three-year term, and a Divisional Director who are jointly responsible for leading their divisions.


Women's & Children's Services

  • Children's Services
  • Paediatric A&E
  • Paediatric theatres
  • Neonatology
  • Obstetrics
  • Gynaecology
  • Reproductive Medicine
  • Paediatric Anaesthesia
  • Paediatric Intensive care


  • General Medicine
  • Adult A&E
  • Respiratory
  • Endocrinology
  • Neurology
  • Dermatology
  • Rheumatology
  • Sexual Health
  • Gastroenterology
  • Care of the Elderly

Surgery, Head & Neck

  • General Surgery
  • Breast Surgery
  • Thoracic Surgery
  • Urology
  • Orthopaedics
  • Maxillo-facial surgery
  • Adult Ear Nose and Throat
  • Ophthalmology
  • Dental
  • Bristol Royal Infirmary and St Michael's operating theatres
  • Central Sterile Supplies Department
  • Critical Care
  • General & obstetric anaesthesia

Specialised Services

  • Cardiac Surgery
  • Cardiology
  • Cardiac Anaesthesia
  • Cardiac Intensive Care
  • Clinical and Medical Oncology
  • Clinical Haematology
  • Homeopathy

Diagnostics & Therapies

  • Physiotherapy
  • Occupational Therapy
  • Orthotics
  • Nutrition & Dietetics
  • Adult Speech & Language Therapy
  • Adult Audiology
  • Laboratory Medicine
  • Pharmacy
  • Radiology
  • Medical Physics & Bioengineering
  • Medical Equipment Management

The Divisional structure and supporting governance arrangements deliver a number of significant benefits for the Trust:

  • Maximising clinical involvement in corporate decision-making
  • Placing accountability closer to the point of resource use
  • Devolving authority closer to the point of service delivery
  • Improving the speed of decision-making, simplifying internal communications and reducing bureaucracy

The Divisions have been established in a way that fosters multidisciplinary team- working, organised around appropriate patient pathways rather than physical boundaries.

Each clinical Division is led by a Head of Division, drawn from a clinical background, supported by a Divisional Manager, Lead Doctor, Head of Nursing, Lead Allied Health Professional, Divisional Human Resources Manager and Divisional Finance Manager. Together with a University representative, lead manager for administrative and clerical functions and other representatives appropriate to Divisional circumstances, these individuals meet formally as the Divisional Board.

Divisions prepare strategic and annual plans.  These are co-ordinated centrally and reviewed corporately through performance management arrangements.

Alongside the Divisional structure, the Trust established designated care pathway leads in areas such as Emergency care, Elective care, Older People's services and Cancer services.  This was to help ensure a focus on the entire patient pathway, particularly where these still cross divisional boundaries. A Clinical Reference Group was put in place to ensure that clinical views were debated and could feed into the different layers of decision-making within the Trust and Divisions.