Foundation trusts revel in new powers, report says
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《英国医生杂志》
Foundation trusts are making the most of their freedoms to invest in new facilities and beds but are not outperforming ordinary NHS trusts, a review by the Healthcare Commission concluded this week.
The review, the first of its kind and the result of visits to the first 20 foundation trusts, also found that four trusts were projecting large deficits of more than ?m ($5.3m; �4.4m).
The commission concludes that, overall, foundation trusts had "hit the ground running" and have wasted no time exercising new freedoms to borrow money and to speed up decisions on opening new wards and operating theatres.
For example, it took just 11 weeks for the University Hospital Birmingham NHS Foundation Trust to plan additional wards and modular theatres—whereas it would possibly have taken two and a half years to go through the strategic health authority, the Healthcare Commission said.
But although there had been no dip in performance no evidence was shown that foundation trusts were pulling ahead on key indicators such as waiting list targets.
Anna Walker, the commission抯 chief executive, said that it was still too early to judge the performance of foundation trusts. "Infrastructure is still being put in place, on which will be built a better level of quality of care," she explained.
Sue Slipman, director of the Foundation Trust Network, which represents all 32 existing foundation trusts and 10 trusts preparing for foundation status, said: "It is hardly surprising the review found that foundation hospitals were not outperforming NHS trusts: they had only been in existence for a few months when the review was carried out.
"However, we have growing evidence that foundation trusts are using their powers to deliver real improvements to patient care."
The report said that warnings about foundation trusts had so far been unfounded. No evidence was found that they were poaching the best staff, avoiding patients with complex conditions, or admitting patients to hospital unnecessarily.
It also had praise for efforts made to engage local people in the running of the trusts—although there was confusion about the roles of governors and the public and patient involvement forums, with competition between the two for volunteers.
But Ms Walker warned the government that it could not ignore foundation trusts?demands for greater financial freedom. They want to raise income from private patients beyond the current cap and to bid for contracts awarded to independent treatment centres, she said.
The Healthcare Commission urged the government to make an "early decision" on whether trusts will be allowed to take over other trusts or expand into primary care.
The report also recommends that the government minimise instability by ensuring that a detailed impact assessment is prepared for any new government initiatives. The financial woes currently hitting four of the trusts, including Bradford Teaching Hospitals NHS Foundation Trust, were to some extent caused by the "turbulence" that the system of "payment by results" has caused, the report said.(Rebecca Coombes)
The review, the first of its kind and the result of visits to the first 20 foundation trusts, also found that four trusts were projecting large deficits of more than ?m ($5.3m; �4.4m).
The commission concludes that, overall, foundation trusts had "hit the ground running" and have wasted no time exercising new freedoms to borrow money and to speed up decisions on opening new wards and operating theatres.
For example, it took just 11 weeks for the University Hospital Birmingham NHS Foundation Trust to plan additional wards and modular theatres—whereas it would possibly have taken two and a half years to go through the strategic health authority, the Healthcare Commission said.
But although there had been no dip in performance no evidence was shown that foundation trusts were pulling ahead on key indicators such as waiting list targets.
Anna Walker, the commission抯 chief executive, said that it was still too early to judge the performance of foundation trusts. "Infrastructure is still being put in place, on which will be built a better level of quality of care," she explained.
Sue Slipman, director of the Foundation Trust Network, which represents all 32 existing foundation trusts and 10 trusts preparing for foundation status, said: "It is hardly surprising the review found that foundation hospitals were not outperforming NHS trusts: they had only been in existence for a few months when the review was carried out.
"However, we have growing evidence that foundation trusts are using their powers to deliver real improvements to patient care."
The report said that warnings about foundation trusts had so far been unfounded. No evidence was found that they were poaching the best staff, avoiding patients with complex conditions, or admitting patients to hospital unnecessarily.
It also had praise for efforts made to engage local people in the running of the trusts—although there was confusion about the roles of governors and the public and patient involvement forums, with competition between the two for volunteers.
But Ms Walker warned the government that it could not ignore foundation trusts?demands for greater financial freedom. They want to raise income from private patients beyond the current cap and to bid for contracts awarded to independent treatment centres, she said.
The Healthcare Commission urged the government to make an "early decision" on whether trusts will be allowed to take over other trusts or expand into primary care.
The report also recommends that the government minimise instability by ensuring that a detailed impact assessment is prepared for any new government initiatives. The financial woes currently hitting four of the trusts, including Bradford Teaching Hospitals NHS Foundation Trust, were to some extent caused by the "turbulence" that the system of "payment by results" has caused, the report said.(Rebecca Coombes)