Foundation trusts explained

What does foundation trust mean?

Foundation trusts (FTs) have a greater degree of managerial and financial freedom, which enables them to adapt services to meet the needs of their patients and the local community.

FTs are membership organisations – they develop services and ensure local needs are met by being accountable to the membership.

We currently have over 20,000 members - made up of patients, carers, staff and local communities.

After the election in March 2009, the Members’ Council worked in shadow form until authorisation in October 2011. They represent the membership and work with the Trust’s Board to influence decision making and ensure all services are continually improving.

Being a foundation trust means improved financial security for the hospital and its services.

Where did the idea come from?

FTs were announced by health secretary Alan Milburn in 2002. They are part of the Government's programme to create a ‘patient led’ NHS. Their stated purpose is to develop decision-making from a centralised NHS to local communities in an effort to be more responsive to their needs and wishes.

Why did we apply to become a foundation trust?

• FTs are run locally with greater freedom from central government. We will be able to work much more closely with patients, the local community, family doctors and our customers, the PCTs, to develop services that make sense to the people who use them. Control, ownership and accountability are placed in the community, staff and those who use the hospital and we will be in a position to respond quickly to the needs of our patients.
• We will be able to involve our members more widely in the life of the Trust.
• Improve our services - Members can tell us what they think about our services and how we can improve them, and we will have the freedom to make changes
• Be a better employer - Our staff will have a greater say and can tell us what we can do to improve their working life.
• Fundraise for special projects - Members will be encouraged to join in with our fundraising efforts on projects where charitable funding is appropriate.
• Contribute to the health of our local economy - As one of the region's largest employers we will work with business partners and the public sector to ensure we are creating maximum opportunities for local employment.
• Develop awareness and understanding - We will engage our members in our efforts to develop the public understanding of our hospitals and how they are run.
• Recruit volunteers - With a vibrant membership we will have an opportunity to encourage volunteering for a range of projects.

Who decided whether or not we should apply?

These decisions are made by the Strategic Health Authority (SHA), the Secretary of State for Health and the Foundation Trust regulator, Monitor.

We had to demonstrate that the organisation:

• Had strong current and ongoing finances
• Had plans for the coming five years that are supported by the organisations that commission our services (primary care trusts), our partner organisations (e.g., the University of Southampton and Hamphire County Council) and the local community 
• Met all appropriate quality and patient safety standards
• Had or was developing governance and leadership arrangements that are appropriate for a foundation trust.

Were there any public meetings about it?

We had to go through a public consultation which took place when we first applied for FT status in 2007. Since then we have continued to engage with the membership through newsletters, events, surveys and the exclusive members area of the website.

What will myself and my family gain from it?

There will be no change to the day to day running of the hospital. What will be different is the way we’re able to make and implement decisions about things like services and investments. This should mean that we will be able to respond more quickly to the needs of our patients and provide better and more effective services for them.

Does it mean the Trust will be privatised?

No, foundation trusts are ‘business-like’ in the way they operate but they are not private businesses.

Monitor grants a license to operate a foundation trust on the basis that the hospital fulfils its obligations to provide NHS services to NHS patients. It will monitor our capacity and capability to provide the hospital services that we have committed to in our contracts with primary care trusts.

A strict limit is placed on the amount of income a foundation trust can earn from treating private patients.

FTs place great emphasis on their role as ‘public benefit corporations’, meeting the health needs of the local community and accountable to the public through the Members’ Council.

Is a foundation trust still part of the NHS?

Yes, definitely. As a Foundation Trust we are still required to meet the Department of Health's national standards on service quality and effectiveness. We continue to be inspected by external organisations such as the Healthcare Commission and other national bodies, who assess our progress and performance.

Will areas such as catering be better or worse?

Because we’ll be able to decide things like how and where we spend our money, it means that our response to service improvement needs should be quicker and more focused. That should lead to improvements.

As an FT, we will be accountable to our membership and will have to listen to them as our key stakeholders and actively seek their views. If the Members’ Council has serious concerns about any area of the hospital they will be in a position to discuss this with Trust board and use their influence to make changes that are deemed necessary.

How can we be sure that the Trust doesn't waste money on things that are nothing to do with patient care?

As an FT we will have greater financial freedoms than other NHS organisations and are not centrally governed. The Trust must be able to be answerable to the membership and the elected Members’ Council in terms of any decisions is makes. 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.  So together we will be able to ensure the money is spent on helping us plan for ongoing and future investments in local services.

Greater financial flexibility will allow us to seek wider funding options for our work and support our mission to deliver world class and pioneering clinical care and research and to collaborate with others to share that knowledge