NHS Foundation Trust Status

In May 2004, our consultation about the possibility of South Devon Healthcare Trust becoming an early NHS Foundation Trust was formally concluded when the Trust Board considered all the responses. Overwhelming support had been received for us to proceed with our application, and the Board accepted the recommendation to go ahead, with minor amendments to the proposed NHS Foundation Trust governance arrangements that had been requested or suggested by local people.

The application was submitted in the summer of 2004, and, on the advice received from members of the public during the consultation, membership was offered as widely as possible direct to people’s homes, in a mailshot to 70,000 recent patients, reaching the majority of households across South Devon.

We successfully retained our top three-star status in July, but later that month we heard that, although we had made a strong application, ministers had decided that the timetable for this Trust to proceed to NHS Foundation status should be slowed down.

This was due to the financial implications arising from new funding rules, announced part-way through our application process, which particularly affected NHS organisations in the South West.

We were asked by the Secretary of State for Health to re-submit our application and became authorised on March 1st, 2007.

What do we plan to do now?

The Trust has continued to perform well and now has a clear understanding of the impact of the new NHS funding regime on its finances.

Our strategy for the future

Our intention remains to build on the opportunities offered by NHS Foundation Trust status to nurture and continue our successful culture of innovation and achievement and to better meet our high quality healthcare aspirations. Our main aims are to:

  • Offer the quickest access to diagnosis and treatment of any hospital in the region
  • Deliver high quality care by creating the best conditions for clinical teams to work in
  • Develop open and effective governance arrangements
  • Improve the working lives of staff to benefit patient care
  • Extensively modernise our facilities, information technology and ways of working.

We have already consulted extensively on our forward plans, as part of our planning for the major development of Torbay Hospital , as well as during our NHS Foundation Trust consultation, and have sought further endorsement from our Foundation membership about our forward-looking “Service Development Strategy” submitted with our Foundation application (December 2006).

Exceptional sign-up

We received an exceptional level of response when we asked for local people to let us know if they would like to be included on our prospective Foundation Trust membership register. More than 20,000 people opted to sign up – which we believe is the best response rate achieved by any potential NHS Foundation Trust anywhere in the country. Local residents and staff can still join as prospective members by calling our Foundation phone line on 01803 655705.

Here is some background information to explain what becoming an NHS Foundation Trust means:

What is an NHS Foundation Trust?

NHS Foundation Trusts are about the NHS being run locally by local people rather than by politicians in central government. They are still accountable to Parliament, but local people will have a real say in running their local hospital.

They are different from existing NHS trusts in three important ways. They:

  • Have new freedom to decide locally how to meet their obligations;
  • Are accountable to local people, who will become members and Governors;
  • Are authorised and monitored by an independent regulator for NHS Foundation Trusts, called Monitor.

The freedoms given to NHS Foundation Trusts are underpinned by a framework of national standards which will safeguard quality and protect the public interest.

Who can become an NHS Foundation Trust?

Eligibility for NHS Foundation Trust status is being restricted to those NHS Trusts with a track record of good performance- those with three stars in the NHS Performance Ratings. However, the test for NHS Foundation Trust status does not rely solely on performance ratings. Suitability to become an NHS Foundation Trust depends on an evaluation of financial performance as well as management, vision and leadership potential.

What difference will this make to people?

Patients will have for the first time a way to direct and shape these organisations and to really influence how they are run. Decisions will be taken locally which means that they will be more responsive to the needs of their patients. For example, if a MRI scanner will improve the service provided to patients, then the NHS Foundation Trust can use existing funds or borrow money to purchase one without the need to refer to a central hierarchy for approval.

The public will have social ownership of their local hospital, with accountability devolved from Whitehall to the local community. They will have a say in how that hospital is run. Local people will have the opportunity to become involved in the running of their NHS Foundation Trust, with rights to elect or become representatives on the governance board.

What does being a member mean?

Members of an NHS Foundation Trust will have a number of important roles, including:

  • Electing their representatives to serve on the governance board
  • Standing for election to the governance board or
  • Putting themselves forward for appointment as non-executive directors – including the chair – of the NHS Foundation Trust
  • Being consulted on plans for future development of the NHS Foundation Trust and its services.

Further information on NHS Foundation Trusts

The Government believes that that securing sustained improvements in NHS performance can only happen when staff have more control and local communities have a bigger say over how hospitals are run.

The programme builds on the values of the NHS. Services will be centred around the needs of patients so that wherever NHS patients are treated they receive high quality care, free at the point of use and based on clinical need, not ability to pay.

Foundation Hospitals will provide health services in line with the requirements of NHS commissioners (Primary Care Trusts). Collaboration will be further enhanced by Primary Care Trusts being included in the governance of an NHS Foundation Trust. This will allow primary care to have greater influence in shaping the direction of the organisation.

Local people, patents and staff are able to become members of the NHS Foundation Trust. The membership must be representative of those eligible. The members will elect representatives to sit on the Governance Board which will represent the interests of the members and partner organisations – like primary care trusts – in the governance of the NHS Foundation Trust. There is also a Board of Directors.

Foundation Hospitals have greater freedom to:

  • run their affairs,
  • innovate and improve care for patients,
  • be controlled locally not nationally. Local public accountability will replace central state control,
  • not be subject to directions from the Secretary of State for Health,
  • retain any operating surpluses and access a wider range of options for capital funding to invest in delivery of new services,
  • not be subject to performance management by strategic health authorities and the Department of Health,

They are not able to:

  • make a profit and distribute it to their members,
  • introduce charges for NHS services,
  • undertake a higher proportion of private work than they did before.
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