Foundation status promise broken by a mile

Health ministers have missed by a mile the goal that every NHS hospital should, by March this year, have had the opportunity to become a foundation trust.

To date just 72 acute hospital trusts out of 171 have acquired foundation trust status – becoming free-standing, self-governing organisations responsible for their own success and failure – and the current pipeline of new applicants appears to have slowed to a trickle.

Monitor, the foundation trust regulator and approver, has geared up to handle 80 applications a year.

However, it is unclear that applications will arrive at that rate. If they do, Monitor’s recently published business plan says that half of all acute and mental health trusts should have been approved by April 2009 – assuming that, as now, two out of three survive the assessment process.

Some NHS regions still have remarkably few foundation trusts. The South East and the East Midlands regions have only four each and South Central only five when, compared with other regions, they should have at least double that number, even at the current rate of progress.

In addition to acute trusts, 24 out of the 57 mental health trusts have achieved foundation status.

But even if good applicants arrive as fast as Monitor is geared to cope with them, about 50 trusts could still be directly managed by the NHS, even in 2010.


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