Differences between the UK NHS Trusts and NHS Foundation Trusts - Coursework Example

Differences between NHS Trusts and NHS Foundation trusts LO Reference Summary Significance To determine what the regulations and oversight of NHS trusts and HNS foundation trusts Department of Health (DH). 2013. The Regulation and Oversight of NHS trusts and NHS foundation trusts: Joint Policy Statement to Accompany Care Bill Quality of Services Clauses. [Pdf]. Available at [Accessed 15 May 2014] The article provides joint policy statement detailing the changes to regulations as well as the oversight of both trusts. These policies have been proposed by the government initial response to issues relating public enquiries. Additionally, there are changes that have been proposed in the article which both trusts should implement. The article is imperative in the research because it will assist in finding detailed policies for both the NHS tryst and the NHS foundation trust. To determine the NHS foundation trust core principles NHS. A short Guide to NHS Foundation Trusts. [Pdf]. Available at [Accessed 15 May 2014] The article gives the principle guiding principles used by the NHS foundation trust. It clearly stipulates the rules and regulations that should be followed when an organization wants to become an NHS. Foundation trust. Additionally it provides information entailing governance, national standards and services. The article is imperative because it will provide information regarding the main guidelines that should be followed when implementing an NHS foundation trust. The learning objective of this article is to determine what NHS trust foundation does. This means their services and members. Imperial College Healthcare NHS Trust. 2014. About foundation trusts. [Online]. Available at [Accessed 15 May 2014] The article stipulates that foundation trusts are part of the NHS and are subject to their rules and regulation. Additionally it shows the difference between the NHS trust and NHS foundation trust. The article will assist in establishing the main services of foundation trusts and at the same time assist in establishing the difference between the NHS trust and the NHS foundation trust. To determine the framework and accountability of the NHS trust boards NTDA. 2013. Delivering High Quality Care for Patients: The Accountability Framework for NHS Trust Boards. [Pdf]. Available at [Accessed 15 May 2014] The article will assist in comprehending the accountability frameworks of such establishments. It will further provide insight on how to create sustainability as well as enhancing it. Additionally, it will help in determining how to improve quality care. This will be a very insightful article because it will assist in understanding how development and support models are established in such organizations. The learning objective of this article is to establish how some of the existing Trust foundations operate. EASTCHESHIRE. 2013. Foundation Trust. [Online]. Available at [Accessed 15 May 2014] The page will give insight into some of the operations experienced in a trust foundation. Further, it provides a definition and how its operations affect people in different areas. This is an insightful web page since it has information that will assist in knowing what some of the trust foundations do. Additionally, the different consultations given by these institutions are provided. The article will assist to determine the quality elements that should exist in both the NHS Trust and NHS Foundation Trust. Care Quality Commission (CQ). 2014. Barts Health NHS Trust: Quality Report. [Pdf]. Available at [Accessed 15 May 2014] This report describes the overall quality that should be provided by trusts all over the world. Despite the fact that it is a report of an individual institution, it provides information about patients’ public as well as other institutions. This article will provide ample information regarding the quality of service by the institutions. This means that all institutions should be able to provide such care and more. To fully comprehend the governing code of NHS foundation trust. Monitor. 2013. The NHS Foundation Trust Code of Governance. [Pdf]. Available at [Accessed 15 May 2014] The article will provide ample information on the NHS foundation trust guiding factors. These guidelines assist in fully delivery of efficient corporate governance and performance. The article will assist in establishing the code of conduct for NHS foundation trust. To fully understand the quality delivery of services by the NHS Trust. NHS. 2008. NHS Choices: Delivering for the NHS. [Pdf]. Available at [Accessed 15 May 2014]. This article provides insight into how in the future; NHS will provide universal services to its clients. Additionally, it will be able to provide personal services without the help of a second party. NHS will therefore be able to engage with their customers and provide overall healthcare services. This is a very insightful article that will provide information on how different NHS organizations will be providing assistance to their customers. To fully determine the essence of patients (clients) in an NHS foundation trust Department of Health (DH). 2013. Patients First and Foremost: The initial Government Response to the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. [Pdf]. Available at < https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170701/Patients_First_and_Foremost.pdf> [Accessed 15 May 2014]. The article articulate the principal humanitarian values that are provided by the NHS foundation trust. It shows that patients should be considered first before anything else. This article will assist in establishing the kind of values that should be established in an NHS foundation trust. To fully understand the essence of NHS trust and its focus. National Audit Office (NAO). 2011. Achievement of foundation trust status by NHS hospital trusts [Accessed 15 May 2014]. This article provides information on how NHS trusts should be run. Additionally, the article further states that such the institutions should be held accountable for their actions. It also provides ample information about policies and regulations that should be followed. This is a very important article that will assist in further elaboration of policies and other information. Introduction The National Health Service (NHS) refers to a United Kingdom umbrella body that comprises of four healthcare systems funded by the government using tax money. These healthcare systems oversee provision of a wide range of health services, most of which are assessed free of charge by UK residents. The NHS further encompasses distinctive healthcare corporations or hospitals responsible for actual delivery of healthcare services. These establishments are referred to as trusts. Prior to implementation of healthcare reforms, these healthcare facilities were simply referred to as NHS trusts. However, in accordance with recently executed changes, the trusts are expected to all change to NHS foundation trusts. The name change is accompanied by actual changes in management rules and actual operations. This research paper seeks to examine these changes to the NHS and the resultant differences between NHS trusts and NHS foundation trusts. Background Despite the increased publicity of NHS foundation trusts in the recent past, research reveals that they were initially established in the year 2004. However, the NHS changes gained momentum in mid 2013, when the new health commissioner, that is, NHS England got the legal mandate and accepted responsibilities to oversee administration of the organization. Under the previous system, several NHS health trusts were responsible for management of government funded healthcare in England (Department of Health (DH), 2013, pp. 45-50). These included mental and community health services. Further, NHS hospital care planning and provision was primarily carried out by primary care trusts, strategic health establishments, and Department of Health (DoH). However, under the newly implemented program, these trusts are projected to change to foundation trusts, also known as foundation hospitals in the course of the year. This transition is to be facilitated by the UK’s NHS Trust Development Authority (NHSTDA), in order to ensure a trouble free transformation of the country’s health sector for the better. Introduction of foundation hospitals marks a significant change in the health sector’s history, especially in regard to the manner in which care services are provided and managed. Since their inception close to a decade ago, the foundation trusts have brought about several changes in healthcare. For example, acute, specialist and mental health NHS trusts are increasingly seeking foundation status. This is because the foundation status empowers healthcare organizations to provide local people with services of high quality, at a relatively low cost. In addition, these relatively new foundation trusts are a crucial element in government’s long term plan to create a National Health Service that is led by patients. This is unlike in the past NHS trust system, where people were left out of critical decision making efforts concerning their health, as the central government controlled everything that took place in the healthcare sector (NTDA. 2013, p.15). Therefore, the NHS foundation trusts are aimed at facilitating decentralisation of decision making and strategy formulation in the health sector. Successful implementation of these changes is expected to ensure that local communities and health organizations respond more than they previously did, to the needs and desires of patients. Key Features of NHS foundation trusts It is imperative to first identify the principal features of NHS foundation trusts, in order to fully understand the differences between them and their immediate forerunners, that is, the NHS trusts. The first distinctive feature about foundation hospitals is that they are primarily nonprofit establishments seeking to purely benefit members of the public. These corporations form part of the NHS system and are responsible for providing more than half of all hospital, ambulance and mental care services. These foundation trusts provide the said services, while strictly following the NHS values of free and high quality care, founded on patients’ need and not their capacity to pay for the services. Another principal attribute of these trusts is that they constitute the UK government’s dedication to ensuring that people access public services on their terms and based on their needs. This is aimed at encouraging local people, who are the actual recipients of healthcare services, to actively participate in creating and developing services that effectively meet their needs, as well as, those of communities at large. In addition, and contrary to a common belief, foundation trusts are an integral NHS component. This means that they are subject to the standards, ratings, regulations, and inspections that govern the NHS. As a result, they are legally required to deliver healthcare services of high quality to patients, just like the NHS trusts. The other key feature of this class of trusts is that they are created under a law that allows for public ownership. Consequently, they support higher involvement of staff members, the public and patients, instead of intense control by the Department of Health. This is a legal framework that builds on individuals’, staff’s and the entire public’s sense of owning respective healthcare facilities, thus fostering dedication to increased efficiency of hospitals. In line with the aforementioned attributes, it is apparent that NHS foundation trusts adopt democracy. This is because hospital staff members and locals are responsible for electing representatives to serve as members of the Board of Governors (BOG) in foundation hospitals. In addition, the BOG and the hospital’s Board of Directors, work hand in hand to make sure that the trust runs smoothly in its daily operations. These foundation trusts also do not constitute a way for trusts to privatise and charge patients money for services offered. This is because there is a legal requirement for them to utilise their assets including buildings and land to support their main purpose, which is to provide NHS healthcare services to patients. The legal provision about this strict use of assets protects the foundation hospitals from the possible threat of being controlled by private investors. The fact that NHS foundation hospitals are designed to support accountability is another feature that cannot be ignored. For example, the hospitals are answerable to their local members and to health commissioners, through their Boards of Governors. They are also responsible to the independent NHS Foundation controller, also known as Monitor. This means that if the violate any regulations, the foundation trusts must answer to these parties and pay accordingly. The non-profit making nature of foundation trusts is worth emphasising. This is because, they treat NHS patients free and the income they use to run hospital operations comes from local care trusts of the NHS. Also lined up with non-profitability is the lack of superiority. This means that just because they are recent, they do not overshadow NHS trusts. Instead, relevant authorities are making effort to support NHS trusts to acquire foundation standing. The NHS foundation hospitals also have the responsibility of working together with other organizations associated with the NHS. Accordingly, they are only allowed by law to use their freedom, as long as it works in line with the operations and objectives of their NHS partners. Failure to observe these rules and regulations compromises a foundation hospital’s position and makes it liable to applicable punishment measures. The final and perhaps most important feature of NHS foundation trusts is that they have the ability to alter their services in order to suit the local communities that depend on their services. They also have the freedom to create new working methods that make it possible for them to showcase the healthcare priorities and needs of local communities. It is noteworthy to mention that, all these freedoms are applied within the limits set by NHS standards, thus protecting the basic values of NHS based care. Differences between NHS Trusts and NHS Foundation Trusts With the key characteristics of NHS foundation trusts in mind, it is now possible to examine how they differ from NHS trusts, which are gradually diminishing. The previous section clearly shows that the NHS foundation trusts seek to improve the previous trusts. Therefore, disparities are largely an upgrade for the NHS. For example, while the NHS trusts were controlled by government, the foundation trusts are not. Instead, the latter have extra decision making and strategy formulation freedom. The other noteworthy difference is that, while NHS trusts were supposed to strictly use funds allocated to them by care trusts and government, foundation trusts can retain the extra funds or even borrow to spend on improved patients’ services (NHS, 2013, pp. 23-25). Initially, NHS trusts were only accountable to the Department of Health and other government regulatory bodies, like the NHS. However, the improved foundation trusts are answerable to local communities through their governors and members. The foundation trusts are also responsible to health commissioners, by way of contractual agreements. Further, unlike NHS trusts, foundation trusts must present their yearly financial reports to parliament for proof of accountability. These foundation trusts must also answer to the country’s Care Quality Commission (CQC) in order to confirm that they fully comply with care standards indicated by the regulatory body. While NHS trusts did not previously have to worry about independent auditors, the foundation trusts must bear scrutiny from Monitor, an organization supposed to ensure that the foundation hospitals meet the expectations of all stakeholders in the healthcare sector (). The higher level of freedom held by NHS foundation trusts, in comparison to NHS trusts is yet another significant difference. For example, unlike the NHS trusts, foundation trusts have the ability to continue adding to the surplus money left after effectively meeting their operations. NHS foundation trusts can also keep the money collected after selling their assets. Additionally, NHS foundation trusts have the choice to raise money from both the public and the private sector. In the past, NHS trusts largely relied on hospital managers’ abilities to negotiate for funding. This is no longer the case with NHS foundation trusts. This is because the trusts enjoy an open and fair financial system, which involves payment in accordance with hospital results achieved. Under this financial system, NHS foundation trusts, NHS specialist trusts and NHS acute trusts are paid for healthcare services delivered, based on tariffs set nationally by the NHS depending on activity of a hospital or healthcare facility. As a result, while NHS trusts could barely afford to purchase hospital services that meet local patients’ needs, NHS foundation trusts can easily achieve this and even seek alternative service providers when necessary. Therefore, unlike NHS trusts, the NHS foundation trusts have access to a system that fairly compensates them for services offered. They also get rewards for activity and high quality of NHS care, while giving their patients a chance to choose a treatment plan and funding them in another facility if the treatment is not available. NHS foundation trusts are able to make a decision locally; about the amount of money they require to efficiently run their operations, deliver services and enhance functional capacity. They achieve this without having to seek government approval. This was not possible for NHS trusts, which had to work with the assigned funds without any alternative. Further, NHS foundation trusts can borrow money from private and public sectors after making their budgetary considerations (EASTCHESHIRE, 2013, p. 23). This is an opportunity that was not available to the NHS trusts. NHS trusts depended on guidance and control by the UK Secretary of State for Health. This is no longer the case for NHS Foundation Trusts. This is because by being free of excessive regulation by government, they can now make stronger ties with local patients and communities. NHS foundation trusts also facilitate membership of locals, members of staff, caregivers and even patients at the hospital (Monitor, 2013, pp. 25-30). Unlike the NHS trust, the NHS foundation trust members have the ability to elect the representatives. This way they are able to have Board of Governors that is more focused on fulfilling the needs of the people by fully serving them. The governors are therefore responsible for representing peoples’ interests by enhancing partnership of the people and the local health organizations. This means that individuals have a bigger say compared to the NHS trust members. Additionally, the NHS Foundation Trusts has the capability to direct their services to the local communities. This means that they have the ability to develop new working ways in order to have hospital services accurately reflecting people’s expectations and needs. Despite the fact that NHS Foundation Trusts are run locally remain as parts of the NHS, they have a huge impact kin the community. This is attributable to the fact that they are set up under the “Health and Social Care (Community Health and Standards) Act 2003” to be a legally independent organization (Imperial College Healthcare NHS Trust, 2014, p. 12). This means that the principal purpose of the establishment is the provision of quality services to its members. Therefore, the public is able to receive healthcare in accordance to the core principles of free care, especially for the ones that are unable to pay for services. NHS foundation trusts are able to borrow but with a limit that is set in terms of authorization, as well as, is subject to annual audit review. However, they are allowed to borrow in order to raise their finance in building new facilities as well as improving the already existing ones. Additionally, they are able to borrow funds from the Government and other private sector lenders. This has ensures that they have the ability to offer the best services compared to the NHS trust. The NHS Foundation Trusts are also bound by regulations and should therefore provide protected, essential and critical NHS goods and services. This is because of the fact that the protection covers NHS assets that are needed in order to continue providing their services. Therefore, patients are assured that NHS Foundation Trusts have the capability to continue providing the NHS services which are commissioned and needed locally and that their assets cannot be used as collateral in case of borrowing (NHS, 2008). Significance of the Transformation The NHS foundation trusts are more involved with the locals compared to the NHS trusts. This is because they have the capability of allowing local individuals as well as Trust staff to be members, and make sure that the community can have a say in their operations. This was a huge improvement from the NHS Trusts because a diverse range of individuals become members to further make sure that the local community needs are reflected. Additionally, by allowing the membership scheme, people are better informed on the community in addition to other hospital services (CQ, 2014, pp. 23). Local people are able to represent their views because the NHS Foundation Trusts gives the people power to elect their Governors. This means that there is better democracy since the governors’ work alongside the staff to assist in developing their services. This means that the NHS foundation trusts are more flexible than the former NHS trusts. Flexibility enhances freedom of development especially in forming new partnerships with other imperative organisations and agencies sharing the same interests. This will further assist in to providing new, innovative and improved services in the local communities. Additionally, the organizations have greater financial freedom compared to NHS Trusts. This means that there will be improved quality and standards in the service rendered ((NAO, 2011, p.7). The NHS Foundation Trusts have closer relationships with their patients as well as the local communities through their members and Governors. The newly acquired freedoms provide the NHS Foundation Trusts with the opportunities of developing new solutions in dealing with issue like staff shortages as well as long lines of [patients waiting to be treated. Nevertheless, NHS Foundation Trusts does not work in isolation. This is because of the fact that they are bound by the law to work closely with the partners in the local area. This means that healthcare startegising continues to engage the entire NHS community. However, they still have more freedom in setting up partnerships between healthcare providers. NHS Foundation Trusts therefore continues in delivery of relevant care for the local people. Additionally, they are inspected by other Healthcare Commission to ensure that they are maintaining the required regulations and standards in the service provision. Conclusion It is evident that there are significant differences between the NHS Trusts and NHS Foundation Trusts. This is because of the diverse significant interest of the two organizations especially in their accountability of local public services. The NHS Foundation Trusts are established with governance model which has been rooted in local accountability. Therefore, The NHS Foundation trusts will continue to aid improvement of the health sector. This is primarily because of f their well established relationships with the local people where they provide their serves. Additionally, various mechanisms have been implemented to make sure that their interests are engaging and aimed at providing quality services to the patients as well as the public. With the establishment of NHS foundation trusts, local people have been given an opportunity to influence provision of acute health services all regions. Bibliography Department of Health (DH). 2013. The Regulation and Oversight of NHS trusts and NHS foundation trusts: Joint Policy Statement to Accompany Care Bill Quality of Services Clauses. [Pdf]. Available at [Accessed 15 May 2014] NHS. 2013. A short Guide to NHS Foundation Trusts. [Pdf]. Available at [Accessed 15 May 2014] Imperial College Healthcare NHS Trust. 2014. About foundation trusts. [Online]. Available at [Accessed 15 May 2014] NTDA. 2013. Delivering High Quality Care for Patients: The Accountability Framework for NHS Trust Boards. [Pdf]. Available at [Accessed 15 May 2014] EASTCHESHIRE. 2013. Foundation Trust. [Online]. Available at [Accessed 15 May 2014] Care Quality Commission (CQ). 2014. Barts Health NHS Trust: Quality Report. [Pdf]. Available at [Accessed 15 May 2014] Monitor. 2013. The NHS Foundation Trust Code of Governance. [Pdf]. Available at [Accessed 15 May 2014] NHS. 2008. NHS Choices: Delivering for the NHS. [Pdf]. Available at [Accessed 15 May 2014]. Department of Health (DH). 2013. Patients First and Foremost: The initial Government Response to the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. [Pdf]. Available at < https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170701/Patients_First_and_Foremost.pdf> [Accessed 15 May 2014]. National Audit Office (NAO). 2011. Achievement of foundation trust status by NHS hospital trusts [Accessed 15 May 2014]. Read More