“Transparent and robust regulation” by Monitor, the independent regulator of National Health Service foundation trusts, is helping the FT sector to deliver significant benefits to patients, according to its Executive Chairman Dr William Moyes.

Furthermore, he claims there is growing evidence to show that FTs are offering better-quality, more-responsive services than non-foundation trusts.

“Although NHS foundation trusts were a controversial aspect of the Government reform agenda for health, we believe the concept is increasingly accepted as the benefits to patients become more and more apparent,” he wrote in Monitor’s Annual Report, launched last week.

Foundation trusts were set in law in 2003 to give high-performing trusts greater freedoms to move away from central Government control and give local communities responsibility for delivering acute healthcare services.

This allows each trust more autonomy in managing its own affairs, with more financial and operational freedom, while being assessed by an independent regulator. Each trust has a duty to consult a board of governors - consisting of patients, staff, members of the public and other key stakeholders - in the strategic planning of operations, thereby allowing the best decisions to be made in the interests of the local population.

Most successful year

According to Dr Moyes, foundation trusts enjoyed their most successful year in 2006-7, with the majority turning in the surpluses needed to drive improvement and expansion of patient services.

And commenting on Monitor’s performance during the period, he claimed there was “clear evidence” that the group’s “light-touch but robust regulatory regime” was helping development in the sector. But looking forward, he stressed the importance of ensuring that the Government’s plans for statutory registration, operated by the proposed new regulator Ofcare, do not result in “confusion, duplication or undue bureaucracy.”

“Our main concerns are to ensure clear roles for Monitor and the new regulator that preserve the effective accountability arrangements that currently exist for NHS foundation trusts, and to promote the development of well-specified outcome-based standards for registration,” he said, adding: “We are concerned that poorly specified or unnecessarily operational standards would lead to registration simply adding costs and bureaucracy for no real benefit to patients.”

High failure rate

In addition, he voiced concern over the high failure rate (almost one in three) among trusts attempting to achieve FT status, as this was holding back expansion of the sector. Sue Slipman, Director of the Foundation Trust Network, agreed: “We need greater support for those trusts preparing for foundation trust status," she said, "so that we can build a critical mass of foundation trusts within the NHS and maximise innovation in services that patients want.”

She went on to call on the government for support so that foundation trusts can “continue to take the NHS in a new direction and make a difference for the patients they serve,” and asked for a “demonstrable commitment to devolution and localism, which means fewer constraints on foundation trust financial and operating freedoms,” and more “streamlined regulation, to turn the vision of a proportionate, risk-based regime into reality.”

The current target is to enable all NHS hospitals to apply for foundation trust status by 2008.