Published: 04/08/2005, Volume II5, No. 5967 Page 9
Voting rates among members at the first 20 foundation trusts were close to the turnout achieved in last year's local council elections, a report has shown.
Figures released by the NHS Confederation's foundation trust network show that for the first two waves of trusts, which went live in April and July 2004, the overall turnout by trusts' members was 36 per cent.
This compares well with the June 2004 local council elections, where 40.9 per cent of the public went to the polls.
Foundation trust network director Sue Slipman said the figures were 'enormously pleasing, ' demonstrating a 'very high' level of enthusiasm for foundation trusts among the public. But she added:
'We can always do better.' The report New Voices, New Accountabilities, published today, expresses concern about variation in turnout between trusts, and the level of staff engagement. Among the first cohort of foundation trusts, the turnout varied from 11 to 67 per cent. Only 26 per cent of staff members voted, compared with 53 per cent of public members. And the lack of restrictions on member numbers meant that in the first wave the number of members varied massively from 1,122 to 96,174.
The report suggests that trusts with high membership numbers may struggle when it comes to achieving good electoral turnout. It gives the example of the Royal Marsden trust, which achieved the highest turnout, and had the smallest number of members.
The example 'underlines. . . the need to balance a focus on breadth of membership with the importance of fostering genuine membership engagement'.
Ms Slipman told HSJ there was an issue of quality versus quantity when establishing the membership of a trust. 'Foundation trusts need to ask themselves what the optimum size of a membership is, ' she said.
But the network is keen for trusts' membership profiles not to be prescribed too heavily by Monitor, the independent regulator.
'One size does not fit all, ' said Ms Slipman. 'You want to know you have all your stakeholders represented.' The report also identifies the lack of detail on the role of governors in the 2003 act which introduced foundation trusts as 'a source of real tension'.
It reports a straw poll of governors which found less than half felt there was a clear understanding of their role in their trust.
Gillian Borrie, a governor at Homerton University Hospital foundation trust, told HSJ: 'When we started I do not think anybody knew what we were there to do.' And Harrogate and District foundation trust staff governor Heather Chapman said: 'My understanding is that some organisations include a governor on high-level groups, to tick boxes, but I feel here we are really achieving something.' The report also said Monitor and the Department of Health are drawing up a model core constitution to allow new foundation trusts to meet the authorisation requirements while allowing scope for them to reflect their own circumstances.
Ms Slipman explained that until now, 'foundation trusts have all started from scratch and it has been very costly'. She hoped the constitution would give trusts a 'starter for 10' without imposing a single model for trusts to adopt.
Monitor said it hoped to put the constitution out for consultation by autumn.
www. nhsconfed. org/
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