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Foundation Trust Governance

What are NHS foundation trusts?

NHS foundation trusts are public benefit corporations that are authorised, under the 2006 Act, to provide goods and services for the purposes of the health service in England. They are part of the NHS and provide over half of all NHS hospital, mental health and ambulance services. They provide healthcare in line with the core NHS principles: that care should be universal, comprehensive and free at the point of need.

NHS foundation trusts were originally created under the Health and Social Care (Community Health and Standards) Act 2003. They are free from central government control. This means they have the freedom to make their own decisions, including whether to make and invest surpluses, and to manage their own affairs. However, they are subject to statutory requirements and all have a duty to exercise their functions effectively, efficiently and economically.

What is the governance structure of an NHS foundation trust?

Each NHS foundation trust has its own governance structure, set out in its constitution.
Every NHS Foundation Trust has its own constitution which defines how the Trust’s governance operates. Changes to the Trust’s constitution can take effect only if the amendments are approved by more than half of the members of the board of directors of the Trust voting and more than half of the members of the council of governors of the Trust voting.

The basic governance structure of all NHS foundation trusts includes:
  • Foundation trust members
  • A council of governors; and
  • A board of directors.