Press release

Monitor to strengthen its foundation trust assessment process

Following an independent review, Monitor will tighten up its internal processes for granting foundation trust status to NHS trusts.


Monitor is to tighten up its internal processes for granting foundation trust status to NHS trusts following an independent review into the authorisation of St George’s University Hospitals NHS Foundation Trust.

The review, carried out by Health Group Internal Audit found no evidence of a breakdown in Monitor’s provider appraisal process. It has instead identified areas where improvements could be made to the process.

Monitor has accepted these recommendations in full and will make these changes to its process. These include:

  • strengthening its approach to financial governance by scrutinising the scope of Financial Reporting Procedures and Working Capital reviews to ensure they remain fit for purpose in the current financial environment
  • working with reporting accountants to ensure there is a full and common understanding of the breadth and depth of the work required by them on these reviews
  • obtaining updated third party assurances where there are delays in the authorisation of the applicant trust of one month or more since the previous confirmations were obtained.

Miranda Carter, Executive Director of Provider Appraisal at Monitor, said:

We are committed to being a learning organisation in order to continuously improve what we do.

These changes will ensure our processes mirror the increased financial risk the health sector faces in the current economic climate. It also enhances ability to identify risks in applicant trusts while also providing greater clarity to reporting accountants on our expectations of what their work should cover.

We will continue to monitor the performance of our processes and will make further changes if necessary to ensure they continue to be robust and fit for purpose.

Published 28 January 2016