UK - Stronger governance and financial freedom delivering results for patients

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 8 February 2008




(2008), "UK - Stronger governance and financial freedom delivering results for patients", Leadership in Health Services, Vol. 21 No. 1.



Emerald Group Publishing Limited

Copyright © 2008, Emerald Group Publishing Limited

UK - Stronger governance and financial freedom delivering results for patients


UK - Stronger governance and financial freedom delivering results for patients

Keywords: Corporate governance, Foundation trusts, Healthcare decision making

Stronger governance arrangements and financial freedoms in NHS foundation trusts are delivering real results for patients, according to a new report by the Foundation Trust Network.

Published three years after the creation of these unique NHS organisations, NHS Foundation trusts: the story so far reveals that foundation trusts are using their financial freedoms and better governance arrangements to take the NHS in a new direction. These new organisations are moving the NHS away from top-down decision-making towards locally-owned organisations, with local members, which are able to make decisions in the in the interest of their patients and the community.

The report, launched as a survey of foundation trust chairs and chief executives, reveals that foundation trusts governors are starting to play a crucial role in ensuring that FTs are accountable to their local communities.

When asked to describe the ways in which their governors exert influence:

  • Of chairs and chief executives, 52 per cent said that governors are central to making sure the board is accountable to patients, stakeholders and the local community.

  • A further 30 per cent said that their governors are the face of the trust in their local communities, further promoting local accountability.

  • Foundation trusts not only take their accountability to members and governors seriously; they are also using their FT-status to transform services and become more productive.

Asked what was the most significant impact of becoming a foundation trust upon their trust:

  • almost a quarter of foundation trust chairs and chief executives believe that their new freedoms had enable them to implement projects previously beyond their reach; and

  • a further 22 per cent said that, as a foundation trust, the attention to costs and the “bottom line” is driving efficiency and boosting productivity.

However, the report states that there is still a long way to go. The foundation trust model is still young and all foundation trusts are on a learning curve with many challenges ahead.

For foundation trusts to continue the transformation, they need:

  • a commitment from government to devolution, localism and the foundation trust model demonstrated by fewer constraints on foundation trusts financial and operating freedoms;

  • more streamlined regulation, turning the vision of a proportionate, risk-based regime into reality; and

  • greater support for those trusts preparing for foundation trust status to ensure a critical mass of foundation trusts can be built.

Sue Slipman, director of the foundation trust network, said: “Since the NHS was first created in 1948, hospitals have looked upwards towards Whitehall rather than outwards to patients and the local community. The focus has been on meeting central demands rather than putting patients first. Foundation trusts are starting to change this and there is real evidence that the foundation trust model, with its financial freedoms and new governance arrangements, is delivering real benefits – providing accountability to patients and communities, and new services designed to meet their needs. But there is still more to do. All of those involved in foundation trusts are still learning. However, three years on the improvements are tangible. As we move forward, we need support from government so that foundation trusts can continue to take the NHS in a new direction and make a difference for the patients they serve. We need a demonstrable commitment to devolution and localism, which means fewer constraints on foundation trust financial and operating freedoms, and we need to more streamlined regulation, to turn the vision of a proportionate, risk based regime into reality. We also we need greater support for those trusts preparing FT status – so that we can build a critical mass of foundation trusts within the NHS.”

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