NHS foundation trusts claim their stronger governance and financial freedoms are delivering real results for patients. A new report, ‘NHS Foundation trusts: the story so far’, is published today, three years after the creation of the trusts, and finds they are taking the health service in a new direction.
The report says the improved governance arrangements and greater freedom over finances are allowing the Foundation Trusts to move the NHS away from top-down decision-making towards locally-owned organisations, in which members are able to make decisions in the interest of their local patients and communities. Publication of the report is linked to a survey of foundation trust chairs and chief executives, which reveals that trust governors are beginning to fill a crucial role in ensuring trusts are accountable.
The study found that 52 per cent of chairs and chief executives saw their governors as central to ensuring their boards were accountable to patients, stakeholders and the local community. A further 30 per cent said their governors were the face of the trust in the local community, further promoting local accountability.
The survey also shows that Foundation Trusts are using their status to transform services and to be more productive. Almost a quarter of chairs and chief executives who responded believed their new freedoms had enabled them to implement projects that would formerly have been beyond them. Almost as many felt the attention of Foundation Trusts to costs and the ‘bottom line’ was driving efficiency and productivity.
Today’s report is clear that there is still work to be done as the Foundation Trust model is new and the trusts are still learning. It says that for foundation trusts to continue the transformation they will need a government commitment to devolution, localism and the Foundation Trust model with fewer constraints on trusts’ financial and operating freedoms. It calls, too, for more streamlined regulation and greater support for trusts that are preparing for foundation status so a critical mass of Foundation Trusts can be built.