Foundation trusts making ‘good start’
NHS foundation trusts have made a “good start” in involving local communities and developing services, according to a new report.
But uncertainty about the future of the trust policy and new government initiatives impacted on the trusts’ ability to manage their finances, the Healthcare Commission warned.
The government welcomed the results of the first ever review of the first 20 foundation trusts, highlighting the fact that many of the concerns about the new scheme proved to be unfounded.
Fears that the trusts would poach the best staff or avoid patients with complex conditions were not supported, the report found, and neither was there evidence to suggest that the trusts had pulled ahead to create a “two-tier NHS”.
Most trusts had managed their finances “soundly”, although four faced projected deficits of more than £3 million, it reported.
However, commission chief executive Anna Walker noted that many of the trusts complained that the high number of government policies introduced had put them under “significant pressure”.
“Foundation trusts have made a good start on involving local people and developing services,” she said, adding that the 20 trusts had recruited an average of 5,000 people from their local communities to act as lay governors.
But she added: “There is an important message here for the government. To be successful, foundation trusts need to invest and innovate in the interest of the local community.
“The government is introducing significant new policies such as payment by results, practice-based commissioning and patient choice. To avoid unnecessary instability foundation trusts will need greater clarity about these policies and the impact of them.”
This clarity was required particularly in areas where the move to foundation trusts impacted on the role of other institutions, such as strategic health authorities and public and patient involvement forums.
In response, health secretary Patricia Hewitt said: “The introduction of NHS foundation trusts changes greatly the way in which healthcare is managed and delivered through the NHS.
“Such trusts are designed to sustain, and not displace, the core NHS principles of universality and equity; with access based on clinical need and free at the point of use.
“The government will also consider fully the lessons from this review for the continuing development of NHS foundation trusts.”
However, shadow health secretary Andrew Lansley called on Ms Hewitt to “send a clear signal” that she would press ahead with the foundation trust policy and give trusts more freedom.
“This means removing the cap on private income, giving foundation trusts greater control over borrowing and ensuring that each trust can establish governance arrangements best suited to their needs,” he said.
