Foundation Trust Governors struggling to make hospitals more accountable to public, says The King's Fund

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Foundation hospitals were supposed to be more accountable to their local communities but the local elected governors are struggling to make the new system work - one year on from the launch of the flagship health reform.

This is the finding of a report published by The King's Fund today, which warns that foundation trust governors need more support and guidance in working out their role if they are to help hold foundation hospitals to account for their actions.

The report, Governing Foundation Trusts: A new era for public accountability, explores possible roles for governors drawing on evidence from a national workshop which for the first time brought together foundation trust governors from all over England. Fourteen of the 20 'first wave' trusts were represented at the event organised by The King's Fund.

The workshop revealed that less than half of governors had a clear understanding of their role and less than a third felt they had made a difference. The good news is that most governors (70 per cent) felt confident that they would be able to make a difference in the future.

Report author Richard Lewis said:

'The key question is whether the governors of the new foundation trusts will have enough power to achieve results or whether they will be purely tokenistic and have little impact. Our work suggests that some governors are unsure of their role and do not feel empowered by board directors. This needs to be remedied. If governors and directors are not clear about governors' roles, the result is likely to be poor accountability on a local level.'

Better communication between governors and members - the people who elected them - is crucial , according to the governors who took part in the workshop. Nearly half said they had no effective route to communicate with the members. The governors would also like to be able to network with each other, a national training programme and a national framework setting out in more detail the respective roles of governors and directors.

The King's Fund chief executive Niall Dickson said:

'The government promised that foundation hospitals would make the NHS more accountable. These are early days but our report suggests that as things stand governors are struggling to make this vision reality. Governors will need support to be effective.'

Read the report: Governing Foundation Trusts: A new era for public accountability

Notes to editors

1. For further information or interviews, please contact The King's Fund media and public relations office on 020 7307 2585, or 07831 554927. An ISDN line is available at 020 7637 0185.

2. Foundation trusts were launched in April 2004 and represented a departure in the way health services were held to account. Their formation replaced the traditional accountability of NHS hospitals to the Department of Health and the Secretary of State for Health with a new accountability of foundation trusts to their members, their elected governors and an independent regulator called Monitor.

3. The King's Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through grants. We are a major resource to people working in health, offering leadership and education courses; seminars and workshops; publications; information and library services; and conference and meeting facilities.