In December 2003 the Health and Social Care (Community Health and Standards) Act was passed, allowing the creation of the first NHS Foundation Trusts in April 2004. The government passed this legislation to allow then high-performing three star trusts, like the RD&E, greater independence from the Department of Health in London, giving them the ability to manage their own budgets and shape healthcare services to better meet local needs and priorities.
The RD&E's application for NHS Foundation Trust status was approved in December 2003 and following a rigorous assessment process the trust became an NHS Foundation Trust on 1 April 2004, making it one of the first in the country to achieve this new status.
The new Health and Social Care Act 2012 sets out a number of duties and obligations on NHS Foundation Trusts. The new Act:
- Gives new significant powers to governors, who appoint of replaces the Chairman and Non-Executive Directors, set their remuneration and appraise their performance.
- Monitor, the Independent regulator is now the Economic Regulator, ensuring that there is fair competition.
- NHS Foundation Trusts no longer need authorisation from Monitor, instead they are issued with a Provider License from Monitor.
The reason for being an NHS Foundation Trust is devolution. The government devolved control to make us better able to respond to local needs and more accountable to our local communities including, most importantly, our patients and the public. That is why NHS FTs are called Public Benefit Corporations.
When a trust like the RD&E is granted NHS Foundation Trust status it becomes an independent, public benefit organisation that is no longer subject to direct control by the Health Secretary of Ste for Health. As an NHS Foundation Trust the RD&E is accountable to the local community for the services we deliver, and to the independent regulator, Monitor who ensures that we work within our terms of authorisation and our constitution. The Care quality commission inspects the Trust to ensure services are of the highest quality.
The RD&E is still an NHS organisation and as such will always stand by the main principle that underpins the NHS, that of healthcare provided free at the point of delivery. It will continue to work within national frameworks and to national standards, though with much greater local autonomy for service development.
Local people, patients and staff can become members of the RD&E NHS Foundation Trust and elect their representatives to the council of governors who are expected to hold the board of directors to account for their performance.
Organisations such Clinical Commissioning Groups (which have taken over from Primary Care Trusts) and local authorities also have representatives on the council of governors, but the majority of the governors are elected from among local people.
The council of governors works with the board of directors (Executive and Non-executive) advising on forward plans and helping to develop the strategy for the NHSFT that best suits the needs of local people.
NHS Foundation Trusts have much greater scope to improve local services and respond to local needs and priorities. Members and governors can directly represent the views of local people on these matters.
In part this is because we have more freedom to borrow capital funds from both public and private sector lenders. This gives us greater flexibility to plan and develop services at a pace to suit local people, in response to patient preferences, rather than relying on centrally controlled funding.
The Economic regulator, Monitor (formerly independent regulator for NHS Foundation Trusts) is responsible for making the final decision about which trusts can become NHS Foundation Trusts, for issuing Provider License and for ensuring that each NHSFT works within this licence and within its constitution.
If you are involved in a community or voluntary group or other local organisation we can come and talk to your group about our Foundation Trust and becoming a member, please contact the Foundation Membership Office for further information.
For more information please click on the links in this section of our website. Or feel free to contact the NHSFT office:
RD&E NHS Foundation Trust
Exeter EX2 5DW
Tel 01392 403977