Published: 04/03/2004, Volume II4, No. 5895 Page 4 5

The NHS Confederation has been forced to re-think how it will represents foundations trusts, amid rumours that a number of candidate trusts are considering forming a breakaway group when they go live this summer.

This week the confederation admitted it has been in talks with trusts on the issue.

Policy director Nigel Edwards said: 'We are aware that some foundation applicants feel that they have a need to be represented separately and indeed there are a number of issues that are unique to them - such as working with the [independent] regulator.

'This allows us to put a strong case for different groupings while maintaining a collective voice for NHS organisations and management, 'Mr Edwards explained.

HSJ understands that at a meeting held at the beginning of last month, chief executives from around half of the 25 foundation candidates discussed the consequences of leaving the confederation and setting up a representative body.

According to HSJ sources they stepped back from the move and a note was subsequently sent out to the trusts, resolving 'to enter into discussions with the confederation to identify how a strong and separate identity for the group working with the confederation could be compatible [with their role as foundation trusts]'.

Suggestions that a breakaway group could offer foundation trusts improved influence over the independent regulator, Department of Health policy and government ministers has provoked a backlash among those at the forefront of the controversial policy.

Former health minister and exconfederation chief executive Lord Hunt - a passionate advocate of foundation status - described moves for a separate body as a 'real danger'.

He said foundation trusts could end up repeating the mistakes of the 1990s, when the newly created NHS trusts broke away from National Association of Health Authorities and became the NHS Trust Federation. In 1997 the two groups then underwent what Lord Hunt described as a 'painful' merger to create the NHS Confederation.

He said: 'The argument then about the new trusts was that it was important they didn't go outside the NHS family. There is a real danger that with a breakaway [foundation] body, the public would see foundation trusts as doing exactly that. I am a great supporter of foundation trusts but that would be the wrong direction.'

University College London Hospitals trust chief executive Robert Naylor agreed: 'I think It is important that foundation trusts stay part of the NHS family and part of that is about being within the NHS confederation.'

Among those leading discussions with the confederation has been King's College Hospital trust chief executive Malcolm LoweLauri. Although his trust left two years ago because it believed the confederation did not offer value for money, confederation moves to create a new subsidiary group could see the trust rejoin.

Mr Lowe-Lauri is expected to discuss issue with confederation chief executive Dr Gill Morgan in the next two weeks.