NHS foundation trusts: documents and guidance

Guidance and information for NHS foundation trusts (FTs).

FT bulletin and correspondence

Read the foundation trust bulletins for information on consultations and NHS priorities, guidance updates and announcements.

Correspondence sent by Monitor to NHS foundation trusts, NHS trusts, clinical commissioning groups and other NHS organisations.

Events and webinars

Find out more about Monitor’s upcoming events and webinars for foundation trusts.

Planning and reporting

You must submit an annual plan and quarterly and ad hoc reports to Monitor. These are used to assess risk and to hold your board to account.

  1. NHS providers: shared planning guidance for 2016/17 to 2020/21
  2. NHS foundation trusts: annual reporting manual 2015/16
  3. NHS foundation trust quality reports: 2015/16 requirements
  4. NHS foundation trusts: in-year reporting
  5. NHS foundation trusts: submitting annual reports and accounts
  6. NHS foundation trusts: annual reporting manual 2014/15
  7. NHS foundation trusts: requirements for quality reports 2014/15
  8. NHS foundation trusts: audit code
  9. Urgent and planned care: operational resilience and capacity planning for 2014/15
  10. NHS foundation trusts: improving strategic planning

Monitoring and enforcement

As an NHS foundation trust, you’re monitored according to the risk-based system of regulation set out in the ‘Risk assessment framework’.

If you don’t meet the standards required, Monitor may open an investigation to decide whether to take regulatory action.

  1. Consultation on changes to the risk assessment framework: June 2015
  2. Helping NHS foundation trusts adopt best financial practice
  3. Monitor's risk assessment framework
  4. The NHS provider licence
  5. Updates to Monitor's 'Risk assessment framework'
  6. Monitor's enforcement guidance
  7. Regulation of NHS hospitals


A range of guidance for NHS foundation trust finance staff. This covers year-end accounts, the foundation trust consolidation process and the agreement of balances process.


Good governance is essential in ensuring your NHS foundation trust continues to provide safe, sustainable and high-quality care for patients.

The updated model election rules are on the NHS Providers website.

  1. NHS foundation trusts: Code of Governance
  2. Governance reviews for NHS foundation trusts
  3. NHS foundation trusts: model core constitution
  4. NHS foundation trusts: accounting officer’s responsibilities

The NHS payment system

Monitor and NHS England invite you to take part in shaping the development of the NHS payment system. You can find out more in this collection of publications on the payment system.

  1. NHS National Tariff Payment System 2016/17: a consultation document
  2. 2016/17 National Tariff Payment System: draft prices
  3. 2016/17 national tariff proposals: currency design and relative prices
  4. 2016/17 national tariff proposals: annexes
  5. Engagement on 2016/17 national tariff proposals
  6. Tariff arrangements for your 2015/16 NHS activity
  7. National tariff payment system 2015/16: a consultation notice
  8. National tariff payment system 2014/15
  9. Approved costing guidance
  10. Improving the costing of NHS services: proposals for 2015 to 2021
  11. NHS providers and commissioners: submit locally determined prices to Monitor
  12. Reforming the payment system for NHS services: supporting the Five Year Forward View

Procurement, choice and competition

As an NHS foundation trust, you must comply with the choice and competition conditions of the provider licence.

You can find out more in the collection of publications on procurement, choice and competition.

Mergers and transactions

After a period of public consultation, Monitor updated appendix C of the ‘Risk assessment framework’, which relates to NHS foundation trust transactions.

Integrated care

Under the NHS provider licence, you must not act in a way that is detrimental to the delivery of integrated care.

Improving patient flow

Evidence from Monitor to support local decisions on options for improving patient flow.

  1. Improving patient flow: evidence to help local decision-makers
  2. Moving healthcare closer to home
  3. A&E delays: why did patients wait longer last winter?

Developing your strategy

You can request joining our LinkedIn Strategy and Development Planning group to discuss management issues and best practice.

Developing your staff

Guidance for leaders and directors to develop strategic change to help their organisation meet the challenges of the modern health service.

  1. NHS strategic financial leadership programme
  2. NHS trust and foundation trust non-executive directors programme
  3. Supporting the role of the medical director

Service-line management

Service-line management is an approach to management developed for the NHS by Monitor.

You can find out more in our collection of publications on service-line management.

Reports on foundation trusts

These documents show Monitor tracking the performance of NHS foundation trusts.

You can also read these NHS foundation trusts quarterly performance reports which summarise the performance of the NHS foundation trust sector.

Governors and members

The publications for governors and members provide further information on how governors should carry out their duties.

About Monitor

  1. About Monitor: an introduction to our role
  2. Monitor’s annual plan for 2014/15
  3. Monitor's strategy for 2014 to 2017
  4. Closing the NHS funding gap: how to get better value healthcare for patients
Published 16 May 2014
Last updated 1 February 2016 + show all updates
  1. Added shared planning guidance for 2016/17 to 2020/21.

  2. Added new section on strategy development. Refreshed page with latest updates on tariff arrangements for 2015/16 and accounting guidance documents.

  3. Added FT bulletin and correspondence links.

  4. Updated with 'Detailed requirements for quality reports 2014/15'.

  5. Added the publication: 'Integrated care: how to comply with Monitor’s requirements'

  6. We've added new guidance on mergers and transactions, and an update on NHS trusts in special measures, to the collection.

  7. Added the NHS National Tariff Payment System 2015/16: engagement documents

  8. First published.