The architect of the foundation trust model has called for the scrapping of the NHS Trust Development Authority and the imposition of an all-foundation trust sector.
Alan Milburn, who as a Labour health secretary introduced the legislation that created the first foundation trusts 10 years ago, made the call at a speech delivered to members of the Foundation Trust Network last week.
Mr Millburn, who is now a consultant and chair of private equity group Bridgepoint’s European Advisory Board, called for the current “glacial” authorisation process to be scrapped and for all trusts to be made foundations within three years.
He said: “The TDA should be abolished and its resources made available to Monitor to help turn round those organisations that are in trouble. Some would need to be placed in a special measures category.
“But as a general rule, and as I always intended, all other foundation trusts should then be given greater independence and freedom to run their own affairs.”
He said this would be the end of a “decades-long” journey towards the creation of autonomous organisations that still “operate to common standards and incentives.”
He added that the current system, which sees the TDA responsible for the performance of non-foundation trusts and Monitor responsible for foundations, left the system “overrun with complexity and bureaucracy”.
There are currently 99 non-foundation trusts. Government policy had been to get all trusts authorised by the start of this month.
A spokesman for the TDA said: “Over the last six months the Trust Development Authority has worked closely with Monitor and the CQC to streamline the process trusts have to go through to achieve foundation trust status. We have done this whilst not compromising on testing an organisation’s readiness to deliver high quality care in a sustainable way.
“The TDA has a very clear remit to support and develop NHS trusts so that they can deliver sustainable high quality care to the patients and communities they serve.We remain absolutely focused on that task.
“We are confident that this year, a number of NHS trusts will deliver this high quality care alongside a feasible plan for how they will sustain it in the long term to the level required to attain foundation status.
“The number of trusts that will achieve this will be dependent on a number of factors, not least the trusts’ ability to attain an overall rating of “good” or “outstanding” from the CQC’s chief inspector of hospitals.”