Monitor to regulate all trusts

It says all trusts should become – or become part of – a foundation by the end of 2013-14 but, regardless of this aim, all trusts will pass to Monitor control from April 2013, when strategic health authorities will also be abolished.

A unit in the Department of Health will be created to “drive progress and oversee SHAs’ responsibilities in relation to providers”, says the white paper, Equity and Excellence: Liberating the NHS.

Where trusts and SHAs fail to come up with “credible plans” or trusts are unsustainable, the DH will use existing but unused powers to break them up or force takeovers.

SHAs have been responsible for moving all trusts to foundation status for several years but around half have not made the change.

Health secretary Andrew Lansley’s paper says: “Within three years, we will support all NHS trusts to become foundation trusts. It will not be an option for organisations to decide to remain as an NHS trust rather than become part of a foundation trust and in due course, we will repeal the NHS trust legislative model.”

The separation of primary care trust providers from PCTs will be completed by April 2011, the white paper says, sticking to the ambitious timescale already in place.

Mr Lansley’s proposals also include new freedoms for existing foundations, creating what he described as “the largest social enterprise sector in the world”.

He will create a provider failure regime; make it easier for them to merge; and look at allowing foundations to “tailor their governance arrangements to their local needs”. This may allow for foundations to be controlled by their staff.

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