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What is a foundation trust?

NHS Foundation Trusts - 10 key points

1. Part of the NHS

NHS Foundation Trusts are part of the NHS. They are still be subject to NHS standards, performance ratings and systems of inspection. They treat NHS patients according to NHS quality standards and principles – that is, free care based on need, not ability to pay.

2. Public benefits

NHS Foundation Trusts are established as independent public benefit organisations. They are modelled on co-operative and mutual traditions. NHS Foundation Trusts are 'owned' by the local communities they serve. Department of Health control will be replaced by local accountability to patients, hospital staff and the public.

3. Democratic

NHS Foundation Trusts are democratic. Local people and hospital staff directly elect representatives to serve on the NHS Foundation Trust’s Council of Governors. The Council of Governors will hold to account the Board of Directors (which is responsible for day-to-day running of the Trust) and appoint the chair and non-executive directors.

4. No privatisation

NHS Foundation Trusts will prevent privatisation of the NHS. NHS Foundation Trusts will be legally required to use their assets to promote their primary purpose of providing NHS services to NHS patients.

5. Clear accountability

NHS Foundation Trusts operate within a clear accountability framework. They will not be left to ‘sink or swim’. They will not be allowed to ‘cherry pick’ services or be set loose to pursue organisational goals at the expense of the local strategic vision.

6. Not for profit

NHS Foundation Trusts are there to treat NHS patients, not to make profits or to distribute dividends. Most income will come through agreements reached with Primary Care Trusts (PCTs) to provide services for NHS patients at the national tariff rate. Private income for NHS Foundation Trusts is capped.

7. Devolution and decentralisation

NHS Foundation Trusts are at the cutting edge of the Government’s commitment to devolution and decentralisation in the public services. They are not be subject to direction from Whitehall. Local managers and staff, working with local people rather than remote civil servants, have the freedom to innovate and develop services tailored to the particular needs of their local communities.

8. Not elitist

NHS Foundation Trusts are not about elitism. All NHS Trusts will get help and support over a four or five year period so that they too have the opportunity to apply for foundation status.

9. Partnerships

NHS Foundation Trusts work in partnership with other NHS organisations. They have a legal duty to co-operate with other local partners using their freedom in ways that fit with NHS principles and are consistent with the needs of other local NHS organisations. They are accountable to the Regulator (who is esponsible to Parliament) and will be inspected by the new Commission for Healthcare Audit and Inspection, which will award performance ratings.

10. Reflecting local needs

NHS Foundation Trusts will be able to gear their services more closely to the communities they serve. They will have freedom to develop new ways of working which reflect local needs and priorities. This will be done within an NHS framework of standards and inspection that safeguards the quality of NHS care. Direct elections of governors by local people and staff will get local hospitals better focused on meeting the needs of the communities they serve. Strengthening public ownership by making NHS Foundation Trusts more locally accountable will help improve services in many areas.