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Monitor publishes NHS foundation trusts’ annual review and consolidated accounts

Monitor, the independent regulator of NHS foundation trusts, recently published the annual review and consolidated accounts for the foundation trust sector.

This review of foundation trusts’ performance for the year 2007-08 supports the case that the foundation model and its regulatory regime is working, delivering robust organisations able to meet the requirements of their commissioners. In general, national healthcare targets are being met, membership is increasing and NHS foundation trusts have demonstrated that they can maintain a strong financial base, deliver efficiencies and build surpluses to invest in improved patient care.

Variation does exist within the sector; Monitor has intervened at five trusts during the year to remedy unacceptably poor MRSA rates, and has intervened formally at one trust in response to concerns about financial governance. However, the Annual Health Check ratings produced this month by the Healthcare Commission show a very positive picture – of the 42 trusts rated ‘excellent’ for both quality of services and use of resources, 38 were foundation trusts.

Over the year 2007-08, the number of NHS foundation trusts increased by 51%. The 89 foundation trusts authorised at 31 March 2008 generated a retained surplus of £395.3 million. This compares with a retained deficit of £2.9 million in the previous year and was £232 million ahead of plan.

Commenting on the surplus generated by the foundation trust sector, Dr William Moyes, Monitor’s chairman said:

“FTs, along with the rest of the NHS, will be exposed to increased financial pressures, but they have the tools – strong boards, good financial management and resources for capital investment - to enable them to deliver the best results for their patients. The challenge now is to get all NHS hospitals to the same position.

“FTs have built up these surpluses by delivering services more efficiently so that the money can be reinvested in improved patient care. In a more challenging economic climate, FTs are strongly placed to use their financial freedoms to deliver these improvements, with patients benefiting from investments in new and improved facilities and higher quality services.

“My message to FTs would be to make pessimistic assumptions in order to be prepared for tough times ahead, and continue to drive efficiencies hard – but this doesn’t mean stop spending. Continue to invest in improvements, working with commissioners to ensure you’re spending intelligently.”

Notes to editors

1. For media enquiries contact: Anna Jefferson on 020 7340 2442

2. The Review and Consolidated Accounts 2007-08 is available from Monitor’s website at

3. Monitor’s operating expenditure fell by 4% over the period 2007-8.

4. Monitor authorises and regulates NHS foundation trusts ensuring they are well-managed and financially viable in order to deliver high quality healthcare for patients. Monitor was established in January 2004. It is independent of government and accountable to Parliament. Monitor’s functions and powers are set out in the National Health Service Act 2006.

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