Are Foundation Trusts a
Good Thing? Issues for
Community Stakeholders
14
Journal of Integrated Care Volume 15 • Issue 1 • February 2007 © Pavilion Journals (Brighton) Ltd
feature
ABSTRACT
This article reviews the government thrust for
foundation trust status for NHS providers, drawing
out implications for public engagement,
partnerships with wider stakeholders and the
relationship with social care services. It explains the
potential benefits of the change, in the context of
expressed concerns about privatisation, the
particular difficulties for community services like
mental health, and uncertainties about existing s31
partnership agreements.
KEYWORDS:
FOUNDATION TRUSTS; MONITOR;
HEALTH AND SOCIAL CARE PARTNERSHIPS;
SERVICE COMMISSIONING
Contact details: frank.lusk@leicspart.nhs.uk
Introduction
It is government policy for all acute and specialist
trusts to be in a position to apply for foundation
trust status by 2008 (DoH, 2005), the ‘provider of
choice’ model for the statutory health economy.
Foundation trusts are considered to be at the
leading edge of the Government’s commitment to
devolution and decentralisation in the public
services, and are at the heart of a patient-led NHS.
It is a fundamental principle that foundation
trusts remain part of the NHS family. As such they
retain a duty to treat patients according to NHS
quality and principles – free care based on need,
not on ability to pay. Lobby groups such as health
workforce unions consider the policy to be
‘privatising the health service’. A major challenge
therefore faces NHS trusts, in the transition to
foundation trust status, in reassuring patients,
carers and staff about the ongoing commitment to
the values of the NHS.
Community stakeholders face a different sort of
challenge. They need to understand foundation
trusts, and how to work effectively with them for
shaping future health care provision. The reality is
that foundation trusts are here and of increasing
importance. The first foundation trusts were
authorised on 1st April 2004, and a total of 52
foundation trusts now operate in England with a
total income of £10.3 billion (Monitor, 2006a).
This represents more than a quarter of acute and
specialist trust pro
vision including, since 1st Ma
y
2006, mental health trusts.
Department of Health predictions are that a
critical number of some 170 acute and specialist
trusts will achieve foundation trust status by the
end of 2008. At such time foundation trusts will
be the main players in local statutory health care
provision. Trusts that have not made the grade
will be vulnerable to merger and acquisition
considerations and Monitor (the body responsible
for authorising, monitoring and regulating
foundation trusts) issued clarification guidance
for this activity in A
ugust 2006 (Monitor, 2006b).
Its view is that, in the fast-changing landscape of
Frank Lusk
FOUNDATION TRUST PROGRAMME MANAGER, LEICESTERSHIRE PARTNERSHIP NHS TRUST