Foundation hospital

NHS foundation trusts are semi-autonomous organisational units within the National Health Service in England. They have a degree of independence from the Department of Health (and, until the abolition of SHAs in 2013, their local strategic health authority). As of February 2016 there were 152 NHS Foundation Trusts

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. The 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, the hospital was allowed to negotiate its own contracts with workers. The governance of the hospital includes local government, trade unions, health workers and community groups.

Foundation trusts were announced by Health Secretary Alan Milburn in 2002. The legislative basis was the Health and Social Care (Community Health and Standards) Act 2003. The first 10 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 the end of 2012, the Monitor website listed 144 Foundation Trusts.

Successive governments have set target dates by which all NHS Trusts are supposed to have reached Foundation status. 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 a number of Trusts which missed the deadline were sacked. It is now officially admitted that a number of Trusts will never reach Foundation Trusts 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 not expected to reach Foundation status.

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