NHS trust

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A National Health Service trust is an organisation within the English NHS generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several trusts involved in the different aspects of healthcare for a resident.

Nature of a trust

NHS Trusts were established under the National Health Service and Community Care Act 1990 and were set up in five waves. Each one was established by a Statutory Instrument.

The trusts are not trusts in the legal sense but are in effect public sector corporations. Each trust is headed by a board consisting of executive and non-executive directors, and is chaired by a non-executive director. There were about 2,200 non-executives across 470 organisations in the NHS in England in 2015.[1] Non-executive directors are recruited by open advertisement. The Trusts which have not achieved Foundation status are now managed by the NHS Trust Development Authority. Board members are, from November 2014, subject to a Fit and proper person test.

All trust boards are required to have an audit committee consisting only of non-executive directors, on which the chair may not sit. This committee is entrusted not only with supervision of financial audit, but of systems of corporate governance within the trust.

Future development

In September 2015 Jeremy Hunt was reported as saying “I think we do have too many trusts as independent organisations" in a context where mergers between trusts and the establishment of chains of hospitals were being discussed.[2] Subsequently Simon Stevens made it clear that he did not expect the remaining NHS trusts to become Foundation Trusts, saying "We are frankly kidding ourselves if we think the non-FTs are going to pass the kinds of criteria that have been set by Monitor."[3]

Types

There are several types of NHS trusts:[4]

Foundation trusts

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Foundation trust status may be applied for by the above categories of NHS trust. Successive governments have announced that all NHS Trusts should become NHS Foundation Trusts, and deadlines have been set for this transformation, which have repeatedly been missed.[citation needed]

Former types

Other types of NHS organisation

Special health authorities

See also

References

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