What are NHS foundation trusts?

NHS foundation trusts are not-for-profit, public benefit corporations. They are part of the NHS and provide over half of all NHS hospital, mental health and ambulance services.

NHS foundation trusts were created to devolve decision making from central government to local organisations and communities. They provide and develop healthcare according to core NHS principles - free care, based on need and not ability to pay.

What makes NHS foundation trusts different from NHS trusts?

  • they are not directed by Government so have greater freedom to decide, with their governors and members, their own strategy and the way services are run;
  • they can retain their surpluses and borrow to invest in new and improved services for patients and service users; and
  • they are accountable to:
    • their local communities through their members and governors;
    • their commissioners through contracts;
    • Parliament (each foundation trust must lay its annual report and accounts before Parliament);
    • the Care Quality Commission (through the legal requirement to register and meet the associated standards for the quality of care provided); and
    • Monitor through the NHS provider licence.

NHS foundation trusts can be more responsive to the needs and wishes of their local communities – anyone who lives in the area, works for a foundation trust, or has been a patient or service user there, can become a member of the trust.  These members elect the board of governors. Find out how to get involved here.

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