The NHS is now half-way to its target for all hospital and mental health trusts to reach the semi-autonomous foundation trust (FT) status. However, the original deadline for all to be FTs was by the end of 2008.

On 1 January 2009, Central Manchester University Hospitals will become the 113th NHS organisation to be authorised as a foundation trust by the independent regulator Monitor.

FTs enjoy independence from direct control by ministers, and are allowed to borrow money against future income and to run temporary deficits within a tight financial operating framework.

Trusts require consistent high levels of quality and financial management to apply for FT status (and about one in ten applications has been referred back or rejected, and FTs have consistently been the trusts rated as the best performers by the Healthcare Commission. FTs’ board are elected by their members (local residents), and they are free to pay above the NHS salary rates and to offer bonuses (although as yet, few do). They can also retin their surpluses for future use in developments.

There has been recent controversy over FT’s private patient income, which was capped at the 2004 level (percentage) of trusts’ turnover. Following a threat of judicial review by UNISON, which claimed FTs were using various joint venture arrangemenets, Monitor recently ruled that income from all joint venture and associate arrangements will count towards FTs’ Private Patient Income (PPI) cap
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The tipping point
Dr William Moyes, Executive Chairman of Monitor, said, “we’re now at the tipping point – halfway towards the goal of an all-foundation trust sector. It’s an important milestone, although one which has taken longer to arrive at than we had hoped.

“Now more than ever - with increased pressure on the NHS to deliver improved quality, safety and patient experience while driving down inefficiency - the capabilities required to get through our tough assessment process and operate effectively as a foundation trust are essential. That’s why I want to see progress accelerate in the year ahead, with more strong applicants coming forward for authorisation”

Health Minister Ben Bradshaw said, ““I am pleased to congratulate Central Manchester University Hospitals on achieving NHS foundation trust status. Half of all eligible acute and mental health trusts have now achieved foundation trust status and this marks a significant milestone in the NHS foundation trust rollout.

“We want as many acute and mental health trusts as possible to achieve foundation status over the next few years, benefiting from the greater freedom it brings, and delivering innovative new services for patients locally.”