FT essentials

Background to NHS foundation trusts

The government is committed to a patient-led NHS. Foundation trusts have been formed to move decision-making away from central government to communities and local organisations. As a result they are responsive to the needs of the patients and accountable to their local communities. NHS foundation trusts have members drawn from patients, the public and staff, and are governed by a board of governors. More information from the Department of Health website on the background to NHS foundation trusts

The purpose of foundation trusts

NHS foundation trusts exist to develop services for NHS patients. They are subject to NHS systems of inspection and follow NHS principles and standards. However, they have greater freedoms to improve services and manage their own affairs as ownership and accountability has been taken away from government and given back to the local community, allowing them to respond to the needs of the local population and improve access to high quality services. More information from the Department of Health website about the purpose of foundation trusts

What is a foundation trust governor?

Governors provide support to the board of directors who manage their trust. Their responsibility is to the board of directors, to the membership and the community. Governors represent the members and partner organisations so they can raise concerns, provide views on plans for future developments and approve appointments of the chief executive, chair and non-executive directors. They are able to feed back information about the trust, its performance and vision to to the constituency they represent. Their role allows the population served by the foundation trust to be directly involved in the management of the trust. The Health and Social Care Act 2003

A short guide to NHS foundation trusts

NHS foundation trusts are part of and subject to NHS standards, systems of inspection and performance ratings – their purpose being to provide care for patients. Uniquely, they have their own governance arrangements where local people are able to become members or governors. They work with the board of directors to ensure the trust acts in a consistent way that follows their terms of authorisation, which are overseen by Monitor. The Department of Health's guide to NHS foundation trusts

NHS foundation trusts – a code of governance

The purpose of this code is to help foundation trusts to improve their governance practices. NHS foundation trusts are now entrusted with public funds and their boards need to operate with sound corporate governance standards. Governors and directors need to be able to understand the principles of governance to enable them to fulfil their roles. More information on Monitor's Code of Governance for foundation trusts

The standards in public life from the Nolan Committee

Governors are required to act in accordance with the seven principles of public life from the Nolan Committee (which apply to everyone in public service):

1. Holders of public office should act solely in terms of the public interest. They should not do so in order to gain financial or other benefits for themselves, their family or their friends.
2. Holders of public office should not place themselves under any financial or other obligation to outside individuals or organisations that might seek to influence them in the performance of their official duties.
3. In carrying out public business, including making public appointments, awarding contracts, or recommending individuals for rewards and benefits, holders of public office should make choices on merit.
4. Holders of public office are accountable for their decisions and actions to the public and must submit themselves to whatever scrutiny is appropriate to their office.
5. Holders of public office should be as open as possible about all the decisions and actions that they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands.
6. Holders of public office have a duty to declare any private interests relating to their public duties and to take steps to resolve any conflicts arising in a way that protects the public interest.
7. Holders of public office should promote and support these principles by leadership and example.

Summary of the Nolan Committee's first report on standards in public life