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New reports on NHS foundation trust governors reveal progress towards local accountability.

NHS foundation trust governors are making local accountability in the NHS a reality, according to new research published yesterday. Two new reports reveal that the majority of governors are clear about their role, have good relationships with their executive board, and are using their statutory powers to make a difference.

Monitor, the independent regulator of NHS foundation trusts, commissioned Ipsos MORI to undertake the most comprehensive analysis of foundation trust governors to date. The Survey of NHS foundation trust governors is independently researched and provides a clear picture of how governors are performing in their new role. Some key findings include:

o Four in five (79%) governors agree that they are clear about their roles and responsibilities. This is particularly true of those who have been governors for longer.

o Around half of governors have been involved in exercising their statutory powers (for example, appointing or removing the chair and non-executive directors, or deciding the remuneration and allowances, and other terms and conditions of office, of the chair and other non-executive directors)

o Governors generally seem to have a good relationship with their chair and executive board. Over eight in ten (84%) governors agree that their chair is doing a good job. However, one in six (16%) are dissatisfied with the level of contact they have with members of the board of directors.

o 70% of governors feel confident they can represent the needs of the trust’s membership, but only 58% of governors feel that their trust is good at communicating its activities to its members.

To accompany this research, Monitor has summarised the findings of the survey and incorporated feedback from governors obtained at the regional events it hosted in March 2008. Developing the role of NHS foundation trust governors, also published today, identifies where opportunities exist for further improvements, including one area – undertaking statutory duties – where Monitor has committed to playing a leading role.

Commenting on the results of the survey and the feedback from governors, Monitor’s Executive Chairman, Bill Moyes, said:

“We are encouraged by the picture emerging from this research. Foundation trusts are the most significant step yet towards a devolved healthcare system and governors are integral to achieving this goal. It is clear from our research that many NHS foundation trust governors are making a difference at the trusts they serve. The legislation that created foundation trusts provides governors with genuine powers. It is therefore important that governors are using these powers effectively and that is why we intend to produce more specific guidance for governors in this area.

“We must also consider that some governors have been serving for longer than others, and that is likely to have an impact on their confidence in undertaking this challenging new role. That’s why we think it’s imperative that foundation trusts share their experiences of the other issues identified in the research and develop solutions through cooperative working.”

“In the modern NHS, foundation trusts can use their governors to ensure patients and the public are at the heart of their future plans. There is evidence that this is already beginning to happen, but there is potential to do more.”


1. The Survey of Foundation Trust Governors was commissioned by Monitor and undertaken by Ipsos MORI. In total Ipsos MORI received 1,328 completed questionnaires – a 55% response rate.

The results of the survey are anonymous. However, the following trusts emerged as best performing in terms of engagement with their governors:

o Bradford Teaching Hospitals NHS FT

o Liverpool Women's NHS FT

o Harrogate & District NHS FT

o Christie Hospital NHS FT

Developing the role of NHS foundation trust governors summarises the research from the survey and the feedback Monitor received from foundation trust governors. The feedback was obtained at four regional events hosted by Monitor in March 2008. The events were attended by governors and chairs from foundation trusts across the country. The report also identifies areas that require further attention in the context of the research, and highlights the work that Monitor is planning to take forward.

Both reports are available from the publications section of Monitor’s website:

2. Additional comments from governors. Both governors featured below attended the event hosted by Monitor in Birmingham on 11 March 2008.

Bernard Everett (Chesterfield Royal NHS Foundation Trust):

“Foundation trusts are a movement in the opposite direction that governments have been going in for generations; they are returning power back to the community, rather than aggregating it all to Whitehall, and that really interested me. The NHS is something we all care about - being a governor means local people can influence decisions on matters that affect their healthcare.

“When my trust was planning a new children’s wing there was a consultation and we had open days where people came along, looked at plans, and gave us their suggestions. It’s a changing culture and I think everyone welcomes it. You might think the head of estates would be apprehensive that governors are messing up their best laid plans, but it’s not like that at all. I think they very much welcome the feedback we give, they find it very reassuring.

“Keeping in touch with the people we represent foundation trust members is a big challenge, and we’re still exploring more effective ways of doing that. We’ve set up an outreach committee to work on membership development, but based on the conversations I have with governors at other trusts I think this is a common problem; how do we actually interact, how do we find out what is concerning people.

“I don’t think an NHS background is essential for all governors, the public doesn’t have one and we are supposed to represent the public. People may be very expert in their field, but they need to explain what they’re doing to the lay man, and that’s how I see my role; I ask sensible questions and get sensible answers.”

Sheila Smith (Chesterfield Royal NHS Foundation Trust):

“Those who have been governors for longer are more confident in the role, they are able to foresee problems and articulate how things can be resolved. When we started, I think most of us saw it as a rubber stamping exercise, but now as we’re growing into the role and developing committees and systems we realise we’re making a genuine contribution.

“I’m starting to find that my trust is a lot more experienced at this than most other foundation trusts, the event hosted by Monitor really highlighted that. It was the first time since I became a governor that I felt more experienced than others. We were one of the first foundation trusts and we weren’t sure how we’d fit into this new role. But now, if governors go to events, such as those hosted by Monitor, there is likely to be somebody who can pass on experience that might help.

“It’s certainly something we would have liked at the beginning when there were so few of us. As new foundation trusts are being authorised on a monthly basis there are a lot of comparatively new governors about.”

3. For further information please contact Michael Moruzzi, Media and Public Affairs Officer, on 020 7340 2438 or 0779 3315084.

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