The Difference Between NHS Foundation Trusts and Trusts...

Working for the NHS
April 1, 2022
The Difference Between NHS Foundation Trusts and Trusts...

NHS trusts and NHS foundation trusts are not one and the same.

There are slight differences between the two that are useful to know if you’re thinking about migrating overseas to start your new life in the UK.

How do NHS trusts operate?

NHS trusts are public sector bodies established by parliamentary order by the secretary of state for health to provide healthcare services to the NHS.

They have a board of executive and non-executive directors, and are accountable to the secretary of state.

NHS trusts are expected to become foundation trusts in due course, and are performance managed by the NHS Trust Development Authority (TDA) on behalf of the secretary of state to support them in this transition.

How do foundation trusts work?

The foundation trust model is a unique expression of local empowerment, created to devolve decision making from central government to local communities.

Foundation trusts have a legal duty to maximise the public benefit derived from the organisation, providing and developing healthcare according to the core values of the NHS. They go through a rigorous approval process, after which they have greater freedoms than NHS trusts to work with their local communities and design their services around local needs.

How are foundation trusts held accountable?

Local residents, staff, patients and service users can become:

  • Members: people who are actively interested in their local foundation trust and want to influence how services are run
  • Governors: elected members who hold the foundation trust’s non-executive directors (NEDs) to account for the performance of the board, as well as representing the interests of the local community

In providing local services, foundation trusts continue to work to national standards and are also accountable to commissioners, the regulators and parliament.

There is a level of accountable autonomy within the foundation trust model where organisations actively engage their staff and community in continual improvement.

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