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Growth of NHS Foundation Trusts
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In April 2004 NHS Foundation Trusts were established initiating a move from a service managed centrally to a local and more patient centred one.
At the end of 2007 there were 77 NHS Foundation Trusts on the Public Register with another 20 who have received support from the Secretary of State and are currently being assessed.
What Makes NHS Foundation Trusts Different?
While NHS foundation trusts provide healthcare according to the core NHS principles of free care based on need and not ability to pay, they have a number of significant differences. NHS foundation trusts are:
- independent public benefit corporations
- free from central government control and strategic health authority performance management
- accountable to local people, who can become members and governors
- free to innovate for the benefit of their local community and patients
- able to make their own decisions on capital investment to improve services
- free to retain any financial surpluses generated and borrow to support investment
Benefits of NHS Foundation Trusts
The benefits to patients include:
- ability to improve relevant care for patients as they are free from central government control
- the freedom to decide on the capital investment required to meet local requirements
- able to borrow in order to support investment without the need to seek external approval.
- can establish stronger connections between local hospitals and local communities through membership. Members are able to stand and vote in elections for Governors of the Trust, forming public ownership and accountability of hospital services accurately reflecting the needs and expectations of local people.
Independent Regulator for NHS Foundations
Founded in January 2004, Monitor is the Independent Regulator of NHS Foundation Trusts. It was established to authorise and regulate trusts and to ensure they are well managed and financially strong while delivering excellent healthcare.
Monitor has a risk-based approach to regulation with parameters set annually. The risk parameters are based on information supplied by the NHS foundation Trusts and ratings reviewed on a quarterly basis.
Monitor ensures trusts comply with the requirements of their authorisation and can intervene in the running if necessary. Grounds for intervention can include the trust failing in its healthcare standards or in other aspects of its activities that significantly breach the terms of its authorisation. Assessing health care standards in trusts is the role of the Healthcare Commission.
The compliance framework applied by Monitor for NHS Foundation trusts comprises of:
- indicators used to derive annual and in-year financial risk ratings
- definitions, thresholds and reporting for major investments
- introduction of service line reporting requirements for under-performing NHS foundation trusts
- refinement of membership plans to greater focus on progress towards the development of a representative membership.
Conclusion
Foundation trusts operate in a different financial regime from other NHS organisations with a financial freedom close to that of commercial organisations. As a result, performance management information assumes an even greater significance. It must facilitate informed decision making based on specific local health care requirements and the monitoring and analysis of all aspects of clinical and operational performance. Key metrics measuring critical activities that drive success in clinical quality and service performance are vital to support CEOs, managers, and clinicians manage the effective specification and delivery of patient care.
Ask the Experts
Oakleigh Consultants has extensive healthcare experience to identify and deliver sustainable improvements in Systems and Processes, Data Quality, Clinical Engagement, Governance Arrangements, Projections on activity based Income/Expenditure, Key metrics, Adoption of Best Practice and Benchmarking.
If you have any questions about the subjects covered in this white paper or you would like to find out more about how Oakleigh Consulting could help your organisation, please contact us on 0161 835 4100 or email us.
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