The original proposals in the Health and Social Care Bill
- All NHS trusts to become foundation trusts by 2014 (NHS Trust Development Authority to assist with the transition).
- Controls on mergers and acquisitions relaxed to facilitate takeovers of failing NHS trusts.
- Providers unable to compete will be allowed to fail. Monitor to have powers to ensure continuity of services at a local level by 'designating' them.
- Private patient income cap on foundation trusts to be lifted.
What has changed in the proposed reforms?
- The 2014 deadline for all NHS trusts to become foundation trusts has been relaxed, although the majority will still be expected to meet this deadline.
- Monitor's oversight of foundation trusts will be extended to 2016 to allow time to build capability of governors.
- Foundation trusts will be required to hold board meetings in public.
- All providers are to be placed under a 'duty of candour' requiring them to be open and transparent in admitting mistakes.
- Amendments to be brought forward at a later stage to revise the failure regime.
- Foundation trusts will be required to produce separate accounts for their NHS and privately funded activities.
What is still unanswered?
- How can NHS trusts be helped to achieve foundation trust status in the current financial context?
- Will necessary decisions be taken to reduce and in some cases close services?
- What will happen to NHS trusts that are not able to achieve foundation trust status by 2014?
- What will the new failure regime look like?