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Frequently Asked Questions

Why are NHS Foundation Trusts being set up?

Department of Health proposals promote the devolution of control in order to make NHS Trusts better able to respond to local needs and be more accountable to local communities for the services it delivers as well as to the independent regulator known as Monitor. All NHS Trusts must become an NHS Foundation Trust by April 2014.

NHS Foundation Trusts have to deliver on national targets and standards like the rest of the NHS, but they are free to decide how they achieve this.

Why do we want to be a NHS Foundation Trust?

Whilst NHS Foundation Trusts remain part of the NHS, we believe that the freedom and flexibility that comes with being an NHS Foundation Trust will provide real benefits for our patients, our staff, and services and the organisations we work with.

We will have :

  • More direct engagement with patients, the public, and our staff through their membership of our NHS Foundation Trust which will help influence the development of our services – They can tell us what they think we are doing well – and areas where they think there is a need for change and improvement
  • Services will be more responsive to local needs.
  • More financial freedom as we will be able to manage our own budgets and shape our services to reflect local needs and and therefore opportunities for investment and development in our services
  • Recognition as an excellent organisation, as we will be subject to a rigorous development and assessment process to become an NHS Foundation Trust.

Are Foundation Trusts still part of the NHS?

Yes, NHS Foundation Trusts are still part of the NHS family and subject to NHS quality standards, performance targets and systems of inspection. We will still treat NHS patients but we will be controlled and run locally rather than nationally. There will be safeguards to ensure we continue to provide NHS services.

The NHS Foundation Trusts will continue to provide care to patients, delivered on the basis of need not ability to pay and that care will continue to be free at the point of use.

What is different about being an NHS Foundation Trust?

NHS Foundation Trusts will be owned by the local communities they serve, via its membership. Having local people, patients and staff on the Council of Governors ensures the NHS Trust focuses on the needs of its local communities.

Local people have the chance to become members and these members will elect their representatives to serve on the Council of Governors – they have an absolute majority. The Council of Governors holds the Board of Directors to account, electing the Chair and Non-executive members of the Board, and approving the appointment of the Chief Executive.

NHS Foundation Trusts have more financial freedoms to develop their services in the way they want; for example any surpluses at the end of a financial year can be reinvested, and capital money can be raised outside of the current lengthy NHS approval processes.

In summary, NHS Foundation Trusts:

  • Have the Freedom to decide locally how to meet their obligations
  • Are accountable to local people, who can become members and seek election to the Council of Governors
  • Are authorised and monitored by Monitor – the Independent Regulator of NHS Foundation Trusts.

Will being an NHS Foundation Trust mean more bureaucracy?

It should mean less as we be scrutinised less by the Strategic Health Authority and Department of Health. Instead there will be an independent regulator called Monitor. Monitor will check we how we are running our services, check our finances etc, but will be less concerned about the detailed decisions we make on services.

What does the structure of an NHS FT look like?

There are three main elements to the way an NHS FT is structured :

  1. A Board of Directors made up of a Chairman, Non-Executive Directors, Chief Executive and Executive Directors
  2. Public, Patient and Staff members are elected as Governors who sit on the Council of Governors.   The Council of Governors works with the Board of Directors
  3. Membership – made up of local public and staff.

What are the benefits to patients and public?

NHS Foundation Trusts have much greater scope to improve local services and respond to local needs and priorities. They have much more flexibility in planning and developing services at a pace to suit local people, in response to patient needs, rather than relying on centrally controlled funding.

What does it mean for staff?

We need effective staff to ensure that NHS Trust is able to deliver the required services. Staff will gain new involvement in developing our way forward through staff membership. Staff are automatically opted-in as members.

How long is the term of office for a Governor?

An elected governor’s term of office will be three years. They can then go for election for a second 3 year term. This means a maximum of 6 years as a Governor.

Why does the Trust need to change its name?

We will need to change our name on authorisation to include the words “Foundation Trust”. With the Trust’s long-term vision of becoming an integrated health and social care provider in mind, and the need to recognise our new geographical diversity, we need to remove the focus on north Devon and the acute hospital.

Click here for a short national guide on NHS Foundation Trusts.