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44-609: South Essex Partnership University NHS Foundation Trust was an NHS foundation trust providing mental health, learning disability, social care and community services across Bedfordshire , Essex , Luton and Suffolk , England. It was involved in running the Aldeburgh Cottage Hospital in Suffolk through a partnership or joint venture with Serco and others. It was named by the Health Service Journal as one of

88-680: A "political vanity project" in April 2017 by Dr Tom Coffey , who is NHS England London clinical director of emergency care. NHS England announced three potential routes for MCP contracts in July 2016: By August 2017 some of these providers appeared to be merging into the proposed accountable care systems . Approved proposals: Models of enhanced health in care homes will enable the NHS and councils to work together to provide more healthcare in care homes, and to provide better preventive services there: Development of

132-549: A "radical upgrade in prevention and public health", but as Dr Sarah Wollaston pointed out in October 2016 there were reductions in other areas of health spending outside NHS England’s budget, in particular public health. Without improvements in social care she said the NHS could not be expected to deliver the Five Year Forward View. NHS efficiency savings of 2% to 3% a year from 2015 to 2021 were supposed to save £22 billion

176-402: A cap on the proportion of their income that can come from non-NHS treatments. It did not only apply to income derived from individual patients, it covered income from all non-NHS sources. This could include joint ventures to develop medical technologies, employers paying for counselling services or income from treating UK military personnel overseas. The Health and Social Care Act 2012 abolished

220-628: A distinction which has lasted in the UK for more than a century - and permit the development of "Accountable Care Organisations" similar to those in Spain and parts of the United States. There is much stress on the fact that 70% of the NHS budget is spent on the management of the 15 million people with long term conditions. Two new models of care – multispecialty community providers, and primary and acute care systems – involve integrating primary care and hospital care in

264-442: A focus on the health of NHS staff, saying that three quarters of hospitals fail to make available nutritious food for nurses and other workers on night shifts. Stevens said NHS staff should set an example by leading healthier lifestyles as part of a drive to improve the health of the nation. He pledged to get junk food out of hospital canteens. The plan also pays far more attention to the potential for technological innovation using

308-487: A link between the community and the board of directors. The size of the council of governors and its exact composition are determined by the constitution of the particular trust. Each trust adopts its own constitution subject to certain restrictions in legislation. These restrictions include that a majority of the council of governors must be elected governors and governors must be unpaid volunteers. Some trusts are more committed to co-operative principles and have even written

352-939: A number of trusts which missed the deadline were sacked. It was accepted by Andrew Lansley that a number of trusts would never reach foundation trust status, and a new organisation – the NHS Trust Development Authority – was established by the Health and Social Care Act 2012 to supervise trusts which have not reached foundation status, of which there were 99 in April 2013, 47 of which were never expected to reach foundation status. The Health and Social Care Bill 2011 , overseen by Lansley, proposed that all NHS trusts become foundation trusts or part of an existing foundation trust by April 2014. The early foundation trusts were generally financially buoyant, but during 2013 and 2014 more faced financial difficulties. A foundation trust finance facility, managed by an advisory committee to

396-570: A shared services solution". By the end of 2013–14, foundation trusts collectively had built up cash reserves of £4.3 billion and it was suggested in the NHS Five Year Forward View that the government would "support" foundation trusts to spend this money "to help local service transformation". In response, the chief executive of the Foundation Trust Network, Chris Hopson, said: "The responsibility for these surpluses lies with

440-500: A single provider organisation. The fact that the word “competition” does not appear once in the document was hailed as a victory by Labour. Stevens said that the health service would have to break out of its “narrow confines” and promote healthy lifestyles. Employers are key to promoting better health in the population and there should be incentives to encourage participation in Weight Watchers-type schemes. The plan includes

484-767: A variety of tests, which have changed over time. In 2003 only trusts with three stars from the Commission for Health Improvement were eligible for foundation status. In that year Aintree Hospitals, Essex Rivers Healthcare, Newcastle upon Tyne Hospitals and Walsall Hospitals were all downgraded to two stars and so did not make the first wave of foundation trusts. Formerly referred to as foundation trust equivalent (FTe) instead of Equivalent Foundation Trusts , this designation applies only to trusts providing high secure psychiatric services, of which there are three: Nottinghamshire Healthcare NHS Trust , West London Mental Health NHS Trust and Mersey Care NHS Trust . These trusts abide by

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528-684: A whole NHS output increased by 47% and inputs by 31%, an increase in productivity of 12.86% during the period, or 1.37% per year, considerably less than envisaged in the Five Year Forward View. 29 areas were selected (from 269 applicants) to pilot new models for localised healthcare in March 2015. When insufficient transformation funding was allocated in September 2016 the plans were scaled down. Proposals for companies to run primary and acute care systems or multispecialty community providers appear to have been prevented because they would be liable for VAT . In

572-414: A year. Between 2004 and 2014 NHS output increased considerably. Hospital admissions increased by 32%, outpatient attendances by 17%, primary care consultations by 25% and community care activity by 14%. Hospital death rates reduced, especially in stroke. At the same time there was an increase in wages of 24% and an increase of 10% in the number of staff and increases in the use of equipment and supplies. As

616-432: Is a staff constituency, a patient constituency, and a "public member" constituency, consisting of members who are neither patients nor staff but live in a defined geographical area. In addition, there are governors appointed by bodies with whom the trust works in partnership. So, for example, appointments may be made by local councils, local medical schools, and local voluntary organisations. Governors are intended to act as

660-569: Is described in Schedule 7 of the National Health Service Act 2006 , with the formal corporate form being called a "public benefit corporation". Each foundation trust has a council of governors. This is made up of elected governors and appointed governors. Elected governors are chosen by a secret postal ballot of the membership, which is open to the general public. The elections are usually held in separate constituencies. Typically there

704-630: Is expected to follow. NHS foundation trust Alan Milburn 's trip in 2001 to the Hospital Universitario Fundación Alcorcón in Spain is thought to have been influential in developing ideas around foundation status. That hospital was built by the Spanish National Health System , but its operational management is contracted out to a private company, and exempt from many of the rules normally imposed on state-owned hospitals, and in particular, that hospital

748-577: Is the first NHS document he could recall that said NHS structures did not have to be the same everywhere. This document, published in March 2017, outlined progress since 2015 and priorities for the next two years. Containing the growth in A&;E admissions and bed days is to be a priority. GP practices are to be organised into area hubs covering populations of up to 50,000. At least 150 new inpatient beds for children and young people with mental health problems are to be provided. There will be reforms to increase

792-535: The Monitor website listed 145 foundation trusts. Successive governments set target dates by which all NHS trusts were supposed to have reached foundation status. For example, by 2009 the Department of Health was promoting "A new type of NHS hospital". In 2011, the 116 trusts then in the pipeline to make applications were required to sign a formal agreement, with a deadline for the application to be made. Board members at

836-675: The NHS 111 is a central issue for most of these projects. It's intended that it should meet all urgent clinical needs rather than just be a signposting service so that appointments could be made directly with GPs or rapid access mental health services. A further wave of 8 new sites were announced in July 2015: In February 2016 NHS organisations in England, both Clinical Commissioning Groups and NHS trusts , were grouped into 44 footprints which were each required to produce joint plans with their local authorities for health and health service transformation for

880-611: The Rochdale Principles into their constitution; they aspire to work closely and in partnership with other mutual and local organisations. At first, foundation trusts were authorised and regulated by Monitor , a non-executive body under the Department of Health. Monitor was merged into NHS Improvement in 2016. The trade body for foundation trusts is NHS Providers , formerly known as the Foundation Trust Network, which has 95% of all acute, ambulance, community and mental health foundation trusts in its membership. A 2014 report by

924-541: The Socialist Health Association said that on the whole after 10 years, "Foundation Trusts [had]... not deepened in terms of democratic practice and participation". The independence of Foundation Trust governors was challenged in 2021 when the governors of Queen Victoria Hospital , a small specialist trust, called for a pause to plans for it to merge with University Hospitals Sussex NHS Foundation Trust . NHS Improvement were said to have effectively ordered

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968-421: The 12 months to September 2017, compared to the 2014–15 financial year, there was a reduction in the rate of hospital bed days per 1,000 population - for Primary and acute care systems 0.5%, for Multispecialty community providers 1.5%, and for the rest of England 1.3%. Both MCPs and PACS saw substantially slower growth in the rate of emergency admissions per 1,000 population than the rest of England. Growth for MCPs

1012-551: The Department of Health definition of a foundation trust, but the Secretary of State for Health maintains a direct line of communication and accountability with them because he or she has the responsibility to provide healthcare to patients who have been detained under the Mental Health Act , and have been judged to pose a grave and immediate danger to the public. Unlike full foundation trusts, governors have no statutory role, and

1056-429: The Department of Health, was established to process loans for capital developments, but during 2014 applications were made by trusts which had trouble paying utility bills or replacing medical equipment. Guidance issued under the tenure of Jeremy Hunt in October 2014 said that conditions could be set which could include: reductions in the use of temporary staff, "use of collaborative procurement routes" or "the adoption of

1100-458: The FTs; any attempt by the statutory bodies to make a grab for them will be furiously resisted". By 2016, the distinction between foundation trusts and other NHS trusts was widely regarded as eroded, and in that year the two regulators were combined into a new body, NHS Improvement . The notion that every trust should become a foundation trust was abandoned, and the widespread financial crisis undermined

1144-489: The Foundation Trust Network it was raised to 1.5%. These caps disappeared on 1 October 2012. Collective earnings from private patients increased 14%, from £346.1 million in 2012–13 to £395.9 million for 2014–15. Private earning is concentrated on specialist hospitals in London who see many patients from other countries. Most trusts have negligible private income. In order to achieve foundation trust status, NHS trusts have to pass

1188-448: The NHS £3.5 million within its first year in 2017. Integrated primary and acute care systems will bring together GPs, hospital, community and mental health services. Money will be directed from a joint budget to wherever patients are judged to need it most: Multispecialty community providers are supposed to bring specialist services, like chemotherapy and dialysis, out of the hospital and closer to people’s homes. They were described as

1232-527: The NHS to reconsider "whether the model of foundation trusts is sensible", arguing "If one-third of the hospital system is permanently not demonstrating good viability and good governance, is that telling you something about actually how the system should run as opposed to how we thought it should run?". In January 2022 Sajid Javid , writing in The Times said he was planning a “revolution” that would allow “well-run hospitals more freedom”. Foundation trusts had

1276-428: The NHS, which is accustomed to the imposition of uniformity regardless of local conditions. It seeks to break away from Enoch Powell ’s 1962 Hospital Plan for England and Wales which established the district general hospital as the central pillar of British healthcare. Even more radical is the proposal to erode the distinction between hospital consultants and General practitioners, encouraging hospitals to employ GPs -

1320-418: The board of directors have no statutory duty towards the governors. The governors cannot, without the board of directors' permission, have any control over the direction of the trust, and cannot appoint or remove trust auditors. The chair and directors are not appointed by their board of governors. Five Year Forward View The Five Year Forward View was produced by NHS England in October 2014 under

1364-537: The council of governors to work towards a merger. A study undertaken in 2005 by the King's Fund of Homerton University Hospital NHS Foundation Trust found some governors disappointed and disillusioned. Another report in 2005, funded by the Nuffield Foundation , found that it was too easy to invite members to sit on sub-committees, where they quickly became bogged down in the minutiae of operational planning, whilst

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1408-436: The earlier plan. This new national leadership of the NHS issues an unprecedented warning to politicians, none of whom are included in the endorsements, that it cannot continue at current funding levels, and additional resources worth more than 1.5 per cent a year in real terms will be required. No more top-down reorganisation was proposed, but instead the development of new models to suit local needs, something quite radical for

1452-561: The internet and mobile phone and apps than any previous NHS document. Technology, it envisages, will enable self-management, integration and patient centred care. This has already been done by the Modality Partnership which is given a favourable mention in the document. It already conducts 75 per cent of consultations remotely using phone or Skype . Patients have an electronic care plan they can manage themselves, and digital access to consultant advice. According to Nick Timmins it

1496-608: The leadership of Simon Stevens as a planning document. It received praise for brevity, being only 39 pages, and lacking the illustrations which had graced its predecessors. Like the NHS Plan 2000 with which Stevens was also associated it was supported by the great and good of the NHS, but in this case it was regulators - Monitor , the Care Quality Commission and the like, rather than the Royal Colleges and Trades Unions of

1540-509: The main decisions were taken at meetings that they only heard about after they took place. The public's perception of foundation trust status implying a high standard of clinical care was changed by the Mid Staffordshire NHS Foundation Trust scandal of the late 2000s ( Stafford Hospital Scandal ) and the ensuing Francis inquiry , published in 2013. At the outset, some critics claimed that foundation trusts went against

1584-455: The number of nurses and reforms to enable more flexible working. Its claims that the NHS could deliver £22bn of annual savings in 5 years’ time, is the latest of a long line of reports to assert that there is scope for the NHS to make major savings, but the report does make it clear that more resources, an extra £8bn in Government funding by 2020 would be needed. It claimed that there would be

1628-533: The private patient income cap but FTs have to do the majority of their work for the NHS. This restriction was kept to reassure those concerned about future developments that FTs would continue to have NHS work as their central concern. Previously each FT had its own cap, set at the level of its private activity when the first FTs were established in 2003/4. About three-quarters of all FTs had a cap of 1.5% or less. Until 2010 all mental health trusts were completely barred from undertaking non-NHS work, but after lobbying from

1672-412: The public sector and less autonomous than was originally expected. By March 2013 there were 145 foundation trusts, of which 41 were mental health trusts and three were ambulance trusts. They included acute trusts, mental health, community and ambulance trusts. By March 2019, the number of foundation trusts had shown a small increase to 151. The basic governance structure and form of foundation trusts

1716-607: The spirit of the principles laid out by Aneurin Bevan , the founder of the NHS. Others feared that it would lead to a two-tier system. Others doubted whether foundation trust members would succeed in having any effective influence over hospital management. In 2011, some argued in a report financed by the Nuffield Foundation that the success associated with foundation trusts had been due to other factors than governance. In June 2014, Bill Moyes, former Monitor executive chair, urged

1760-466: The supposed autonomy when almost all had to rely on money borrowed from the Department of Health, to which strings were attached. Foundation trusts have some managerial and financial freedom when compared to NHS trusts . The introduction of foundation trusts represented a change in the history of the National Health Service and the way in which hospital services are managed and provided. At

1804-599: The time of introduction, they were described "as a sort of halfway house between the public and private sectors". This form of NHS trust is an important part of the United Kingdom government's programme to create a "patient-led" NHS with an internal market . The stated purpose is to devolve decision-making from a centralised NHS to local communities, in an effort to be more responsive to their needs and wishes. But after Gordon Brown prevented plans by Alan Milburn to make them financially autonomous they have been much more in

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1848-440: The top hundred NHS trusts to work for in 2015. At that time it had 5,084 full-time equivalent staff and a sickness absence rate of 5.07%. 65% of staff recommend it as a place for treatment and 55% recommended it as a place to work. It merged with North Essex Partnership University NHS Foundation Trust in April 2017 forming a new organisation Essex Partnership University NHS Foundation Trust . “Significant” service reconfiguration

1892-509: Was 2.6% and for PACS the figure was 1.2%. In the rest of England it was 4.9%. In order to ensure the knowledge from the new models of care was captured and shared throughout the health and care system, the national new care models programme established the FutureNHS collaboration platform, built on the Kahootz collaboration software. An evaluation study of the platform estimated that it has saved

1936-543: Was allowed to negotiate its own contracts with workers. The governance of that hospital includes local government, trade unions, health workers and community groups. Foundation trusts were announced by Health Secretary Alan Milburn in 2002, and the legislative basis was the Health and Social Care (Community Health and Standards) Act 2003 . The first ten NHS hospitals to become foundation trusts were announced in 2004. Gordon Brown prevented plans by Alan Milburn that they should be financially autonomous in 2002. By 2012,

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