News story

New support to enable NHS foundation trusts to tackle their challenges

Monitor is offering NHS foundation trusts a range of tailored and targeted support so they can make better decisions in difficult circumstances and improve services for their patients.


The health sector regulator is developing a number of strands of improvement work aimed at helping foundations trusts maintain their operational performance, as well as continuing to regulate them. These new resources include helping them better plan how to provide patients with quality services now and in the future.

For example, a comprehensive strategic development toolkit will help boards and senior managers devise robust five-year plans. Reviewed and tested across 5 foundation trusts, the toolkit aims to enable trusts to fully assess the level of strategic challenge they face.

A guide for foundation trust board members on their role in developing strategy was launched today at a development conference for leaders of all NHS trusts, hosted by Monitor, the NHS Trust Development Authority and the Foundation Trust Network.

The regulator is concerned that long-term planning by foundation trusts is not robust enough, with many trusts making over-optimistic forecasts of the earnings they are likely to reinvest in providing improved patient services in future years.

Monitor stress-tested the new five-year plans submitted by foundation trusts and found the plans of almost one-third of the sector were potentially exposed to risk in this way. The regulator is working with these trusts to remedy the deficiencies and ensure their plans can deliver sustainability in the long-term.

Stephen Hay, Managing Director for Provider Regulation at Monitor, said:

We remain a risk-based regulator, operating a regime that monitors the performance of all foundation trusts but only takes action in the most serious cases where trusts have breached their licence. Unfortunately that’s more often than it was 5 years ago, but it is still a minority of the sector.

However, we cannot ignore the uncomfortable fact that, against a background of rising demand for NHS services, a majority of foundation trusts are now struggling to maintain their operational and financial performance. In this challenging economic climate, these trusts need more help.

He told the conference in London:

Monitor remains firmly committed to the philosophy of autonomous foundation trusts, and a regulatory model which respects your freedoms to run your own affairs. We are not going to manage your daily performance or look over your shoulder. We are going to offer more targeted, practical help to enable you to take the right decisions in this difficult environment and secure high quality, sustainable services for your patients.

Published 16 October 2014