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Nottinghamshire Healthcare Branch 

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NHS Foundation Trust Equivalent (FTe):

This designation can only apply to NHS Trusts, like Nottinghamshire Healthcare NHS Trust; who provide high secure psychiatric services, at a Secure Hospital, like Rampton.

Whilst the Secretary of State maintains a direct line of communication and accountability with them through their appropriate SHA; under the new structures that are designed to give the appearance of a patient led NHS, these FT equivalents need to add special controls as extras, which will result in a more complex and greater administrative burden.

There are many differences between FTes and thier Foundation Trust counterparts. Most noticeably are the 'Board of Governors'; FTe governors have no statutory duty and FTes don't have a 'private patient cap'.

A quick look at page 5 of this report will clarify some of differences between FTs & FTes.

Related resources:

New link Read about our Trust's application for FTe | 5 questions - FTe feedback form | Purpose of NHS foundation trusts | Monitor & Foundation Trust

Foundation Trusts

Unison and your local Unison branch are not against a progressive, proactive and an evolving NHS; but we are against ‘back doorprivatization of the NHS and it is clear to us that Foundation Trusts are a step on the road to privatization of our public health services.

Purpose of NHS foundation trusts - Last modified date: 9 February 2007

The Health and Social Care (Community Health and Standards) Act 2003 establishes NHS Foundation Trusts as independent public benefit corporations modelled on co-operative and mutual traditions.

The purpose in establishing NHS Foundation Trusts is to:

  • Devolve more power and responsibility to the local level so that NHS hospitals are better able to respond to the needs of patients.

    • This would lead to a multi-tier (region based) health service; with a near 'ring-fencing' of local services.
    • Is this a National Health Service or Local?
    • There is no solid proof that Foundation Trusts perform better than Hospital Trusts.
    • In fact, see our links opposite and throughout this page to get a wider view of Foundation trusts.

  • The establishment of NHS Foundation Trusts aims to bring about improved access to higher quality services for NHS patients by incentivising innovation and entrepreneurialism.

    • We need a government that can recognise and reward good practice and high standards and use the same high standards as a template for ALL hospitals to follow.
    • Entrepreneur; a person who organizes and manages any enterprise/business, usually with considerable initiative and risk. We don't think your National Health Service should be run as a business based on risk and we don't think you want that either.
    • The NHS doesn't need entrepreneurial managers, taking risks; it needs more nurses, better facilities, more training and more money.

  • Devolve accountability to local stakeholders including NHS patients and staff. NHS Foundation Trusts operate governance arrangements that give local stakeholders and the public opportunities to influence the overall stewardship of the organisation and its strategic development.

    • Accountable to patients; despite patients on the board of governors having no legal statutory role like thier FT counterparts.
    • A Foundation Trust equivalence executive board that as no legal statutory duty to its board of governors.
    • I don't think Mid Staffs Foundation Trust's patients wanted the poor services they received.
    • Accountability to staff; despite not having to formerly consult staff or ask them to become members.
    • Accountable to appointed (not elected)stakeholders.

  • Support patient choice by increasing the plurality and diversity of providers within the NHS.

    • Plurality implies choice through voting; yet some of the board of governors of a Foundation Trust Equivalence are appointed without anyone casting a vote.
    • Diversity of providers; from a private service providers; at what cost?

  • We don't think repealing section 35(5)(a); leads to devolvement, accountability and choice.

    [Applying for NHS Foundation Trust Status Guide for Applicants - Part 4 - Pg 21]

    The Local Government and Public Involvement in Health Act 2007 Order 2008 repealed various provision of the 2006 Act with respect to Patients’ Forums. From 01 April 2008, section 35(5)(a) of the 2006 Act was repealed.

    The effect of repealing this provision; was the deletion of the requirement for an NHS trust, FT or FTe applicant, to consult with its staff.

    ** NO STAFF CONSULTATION REQUIRED **