About foundation trusts

What is an NHS foundation trust?

NHS foundation trusts are a new type of organisation created under the Health and Social Care Act 2003. They remain part of the NHS and subject to NHS standards, performance ratings and inspection but are free from central government control. They continue to provide free care based on need.  

Foundation trusts operate like mutual organisations, for example, like some building societies. They have a membership of local people, service users, carers, and staff. The membership elects a Council of Governors (also called a Members' Council), which helps make decisions about how the foundation trust is run.

What makes them different from NHS trusts?

Foundation trusts are:

• free to decide how to meet their responsibilities
• accountable to local people, staff, service users, their carers and partners, who can become members and governors
• authorised and regulated by Monitor, the independent regulator of NHS foundation trusts.

What are the benefits?

Foundation trusts have the freedom to decide locally on the investment needed to improve and develop services. 
They are able to borrow up to agreed limits and keep any surpluses for reinvestment for services and facilities.
People who make up the membership have a greater say in how the Trust develops its services.

More information

To find out more about NHS foundation trusts please visit:

• Department of Health website
• Monitor website (the independent regulator for foundation trusts).