The Health and Social Care Act 2003 (external link) established NHS Foundation Trusts as independent public benefit corporations – new organisations in the NHS based on co-operative and mutual models. They are part of the NHS, and subject to NHS systems of inspection. They treat NHS patients according to NHS principles and NHS standards, but they are controlled and run locally, not nationally.
NHS Foundation Trusts
- have to deliver on national targets and standards like the rest of the NHS, but are free to decide how they achieve this
- have increased freedoms to retain any operating surpluses and access a wider range of options for capital funding to invest in delivery of new services
- recruit and employ their own staff
- are not subject to directions from the Secretary of State for Health
- are not subject to performance management by Strategic Health Authorities and the Department of Health.
There is an independent regulator for NHS Foundation Trusts: Monitor (external link) (whose statutory name is the Independent Regulator for NHS Foundation Trusts).
NHS Foundation Trusts and complaints
NHS Foundation Trusts have their own systems for the internal handling of complaints, which may differ from the local resolution procedure outlined in the regulations, including separate arrangements for performance management.
The independent review stage operated by the Healthcare Commission applies to NHS Foundation trusts, which are also covered by the Health Service Ombudsman. In the case of a foundation trust, the Healthcare Commission’s remit has now been broadened to bring it into line with complaints about NHS bodies.
The Healthcare Commission can consider a complaint which
(a) is made by a patient or any other person who is affected by, or likely to be affected by, the action or omission of the NHS foundation trust which forms the likely subject matter of the complaint; and
(b) is reasonably connected with the provision of health care or other services to patients by or for the NHS foundation trust.
The request must be received by the Healthcare Commission within six months (or, if this is not possible, as soon as reasonably practicable) of the outcome of the response from the foundation trust.
The amended regulation replaces the Healthcare Commission’s obligation to send copies of all complaints about foundation trusts to the Independent Regulator of NHS Foundation Trusts, Monitor (external link) with a regular reporting requirement. It enables the Healthcare Commission to send copies of complaints to the Independent Regulator, provided it has the consent of the complainant, either of its own volition, or at the request of the Independent Regulator.
The regulations will also enable Monitor to require the Healthcare Commission to send it any particular types of complaints it is interested in. This will remove an unnecessary administrative burden and replace it with a more focussed and useful set of information being shared with the Monitor.
The Healthcare Commission may consider that certain other complaints should be copied in detail to Monitor. In this instance, they may copy the complaint and final independent review report to Monitor for their information, upon receiving permission to do so from the complainant.
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