Frequently asked questions

  • Does the chair of the board also chair the council of governors?

    Yes, the chair of the NHS foundation trust board of directors is also the chair of the NHS foundation trust council of governors.


  • Is a council of members different from a council of governors?

    No; some NHS foundation trusts have chosen not to use the term "council of governors" and various alternatives are used instead, including:

    • council of members;
    • membership council
    • members’ council; and
    • governors body.

  • What role do quality accounts play in public accountability?

    Boards must be transparent on performance and plans – they need to engage patients and the public in evaluating performance and determining plans. Monitor requires NHS foundation trusts to report on the quality of care their organisations deliver and how they plan to improve it as part of their annual reports. Quality reports help to develop more transparent and accountable public reporting and ensure that boards have clear priorities and achievable plans in place for driving improvement. Patients and the public can use this information to hold boards to account on the commitments they make.


  • Who decides the remuneration of directors at NHS foundation trusts?

    NHS foundation trusts are autonomous organisations, and appointments and remuneration is one of the areas where they are able to make their own decisions. The governance structure has been designed to make sure that directors (both executive and non-executive) are held to account for their performance and are prevented from deciding their own remuneration.

    The council of governors is responsible for deciding the remuneration and allowances, and the other terms and conditions of office, of the chair and the other non-executive directors.

    Any remuneration matters are therefore contractual issues between the trust and its staff. The NHS Foundation Trust Code of Governance states: "Levels of remuneration should be sufficient to attract, retain and motivate directors of the quality required to run the NHS foundation trust successfully, but an NHS foundation trust should avoid paying more than is necessary for this purpose."


  • Where can I find foundation trust standing orders in relation to meetings of directors and governors?

    Monitor is required, by law, to maintain a register of NHS foundation trusts. This is called the NHS foundation trust directory, available on this website. The directory includes the terms of authorisation for each NHS foundation trust, which sets out the obligations under which that trust must operate. The terms of authorisation include a constitution, and where the standing orders form part of the constitution of an NHS foundation trust, they will be available in the directory. However, not all constitutions include the standing orders; for example, the earlier NHS foundation trusts that were authorised by NHS foundation trusts that were authorised by Monitor tend not to include the standing orders in their constitutions.

    Where an NHS foundation trust proposes to amend its constitution, any amendment must be approved by Monitor. Such approval is required for any amendment to the standing orders where the standing orders form part of the constitution.


  • As a governor, what can I do if I feel there is a serious problem at my foundation trust?

    If governors feel that a foundation trust is in breach of its authorisation, or that a breach is imminent, it is very probably in the trust’s wider interests for governors to contact Monitor to share their concerns, via the lead governor. Details of Monitor’s relationship manager for each NHS foundation trust are available in the NHS foundation trust directory. For more information on communication between governors and Monitor, please see the Guide to Monitor For NHS Foundation Trust Governors.


  • What can I do if I have a disagreement with the chair of the trust?

    If you are unable to resolve the issue, you can talk to the senior independent director (SID). The SID is one of the independent non-executive directors and is appointed by the board of directors in consultation with council of governors. He or she should be available to members and governors if they have concerns which contact through the normal channels of chairman, chief executive or finance director has failed to resolve, or for which such contact is inappropriate. Alternatively, you could speak to another non-executive director.


  • How is the council of governors comprised?

    The council of governors of an NHS foundation trust is established by the National Health Service Act 2006. The Act sets out how the council of governors is to be comprised; it must include elected representatives of the members of the NHS foundation trust, and also individuals who have been appointed by the trust to represent certain interests (such as a primary care trust and local authority governor).


  • What is the difference between elected and appointed governors?

    Elected governors are elected to the council of governors by the members of an NHS foundation trust. Appointed governors are representatives from certain key stakeholders, such as a primary care trust that commissions services from the NHS foundation trust, and a local authority – they are appointed to the council of governors to represent those stakeholder groups. The National Health Service Act 2006 requires that more than half of the board must be elected from the public and (if there is one) patients' constituencies. Therefore, although appointed governors have equal rights (i.e. one vote), elected governors form the majority of members on the council of governors.


  • What are the Model Election Rules?

    The Model Rules for Elections can be found on the Department of Health website. The rules make provision for both first-past-the-post and single transferable voting but not electronic voting.

    The requirement to declare membership of a political party is a requirement of the Model Election Rules, which NHS foundation trusts are required to adopt as part of their constitution.


  • When does the clock start ticking on non-executive directors’ appointments?

    The NHS Foundation Trust Code of Governance states the specified terms that non-executive directors should serve. The time a non-executive director has been appointed is taken from when that trust became an NHS foundation trust.


  • Where can I go for more advice and support?

    The links to other organisations give details of both the Foundation Trust Network and the Foundation Trust Governors' Association which can offer further advice and support. For details on contacting Monitor, please have a look at the page on lead governors.