As part of the reforms to the NHS, all NHS trusts were expected to become foundation trusts by April 2014, and the Health and Social Care Act 2012 outlined a new failure regime for providers that are financially unsustainable.

The provider reforms received little attention during the debate on the Act, but are very important. The 2014 deadline was removed, but the Trust Development Authority (TDA), created by the Act to steward non-Foundation Trust to Foundation Trust status, was given a remit of four years to complete its work, giving a deadline of April 2016. The Act built on a system for handling financial failure, outlined in the 2009 Health Act, and introduced the role of trust special administrator (TSA) that would take over a failed organisation.