An NHS foundation trust is a semi-autonomous organisational unit within the National Health Service in England.
Alan Milburn's trip in 2001 to the Hospital Universitario Fundación Alcorcón in Spain is thought to have been influential in developing ideas around foundation status.
[5] Successive governments set target dates by which all NHS trusts were supposed to have reached foundation status.
A foundation trust finance facility, managed by an advisory committee to the Department of Health, was established to process loans for capital developments, but during 2014 applications were made by trusts which had trouble paying utility bills or replacing medical equipment.
Guidance issued under the tenure of Jeremy Hunt in October 2014 said that conditions could be set which could include: reductions in the use of temporary staff, "use of collaborative procurement routes" or "the adoption of a shared services solution".
The stated purpose is to devolve decision-making from a centralised NHS to local communities, in an effort to be more responsive to their needs and wishes.
[16] Elected governors are chosen by a secret postal ballot of the membership, which is open to the general public.
A 2014 report by the Socialist Health Association said that on the whole after 10 years, "Foundation Trusts [had]... not deepened in terms of democratic practice and participation".
[21] A study undertaken in 2005 by the King's Fund of Homerton University Hospital NHS Foundation Trust found some governors disappointed and disillusioned.
[citation needed] Another report in 2005, funded by the Nuffield Foundation, found that it was too easy to invite members to sit on sub-committees, where they quickly became bogged down in the minutiae of operational planning, whilst the main decisions were taken at meetings that they only heard about after they took place.
[22] The public's perception of foundation trust status implying a high standard of clinical care was changed by the Mid Staffordshire NHS Foundation Trust scandal of the late 2000s (Stafford Hospital Scandal) and the ensuing Francis inquiry, published in 2013.
At the outset, some critics claimed that foundation trusts went against the spirit of the principles laid out by Aneurin Bevan, the founder of the NHS.
[23] In June 2014, Bill Moyes, former Monitor executive chair, urged the NHS to reconsider "whether the model of foundation trusts is sensible", arguing "If one-third of the hospital system is permanently not demonstrating good viability and good governance, is that telling you something about actually how the system should run as opposed to how we thought it should run?".
[24] In January 2022 Sajid Javid, writing in The Times said he was planning a “revolution” that would allow “well-run hospitals more freedom”.
This could include joint ventures to develop medical technologies, employers paying for counselling services or income from treating UK military personnel overseas.
The Health and Social Care Act 2012 abolished the private patient income cap but FTs have to do the majority of their work for the NHS.