Foundations will not 'take over the world'

Foundation trusts will not be allowed to 'take over the world' and damage commissioning relationships within the NHS, the independent regulator has warned.

The first 10 trusts are launched today, following a three-year government battle to create the controversial organisations which will be free from ministerial control.

Drawing parallels with the behaviour of the first-wave NHS trusts, independent regulator Bill Moyes said: 'This is not going to be like the arrival of the original trusts in the early 1990s, some of whom thought they were going to take over the world.'

He warned that without providers and purchasers working closer together, the NHS would fail to realise the benefits to patient care made possible through the policy. Mr Moyes stressed that he would intervene if a foundation trust refused to act in the wider interests of the NHS, as laid down by its operating licence.

His comments follow the anger expressed privately by primary care trusts about the pressure they apparently faced to sign threeyear legally binding contracts with potential foundation trusts.

Elements of service planning, it was alleged, had been sacrificed to protect the financial viability of foundations because of the political need for them to succeed.

Mr Moyes said: 'One of my biggest concerns is around commissioning capacity, whether secondary or primary care.What we need is a relationship with commissioners that functions like a partnership, with the organisations meshing together. In some places - even when the relationships are working - that hasn't happened as much as it could.'

And he urged strategic health authorities to back PCTs if they struggle to negotiate with new foundations trusts: 'The lack of [commissioning] capacity may mean that consortia need to develop to do the complex commissioning. It is not for me to say, but there may be a role for SHAs to provide support to commissioners.'

And in a move towards greater co-operation, Mr Moyes suggested that foundations could look at operating open-book accounts, allowing PCTs access to detailed cost information.

Of the 12 trusts in the first 'cohort' of applications wishing to launch this week, two announced on Tuesday that they would defer their applications.

The regulator's office said the applications from North Tees and Hartlepool trust and Rotherham General Hospitals trust had not been rejected, and that the trusts were still able to reapply and be reassessed with future cohorts.

North Tees and Hartlepool said it retained a commitment to winning foundation status but wanted to 'gain a further understanding of the effects' of payment by results and to 'shape service development strategy with further input from the public'.

Rotherham refused to comment as HSJ went to press.

Off the mark:10 first-wave foundations get the go-ahead

Basildon and Thurrock University Hospitals

Bradford Teaching Hospitals

Countess of Chester Hospital

Doncaster and Bassetlaw Hospitals

Homerton University Hospital

Moorfields Eye Hospital

Peterborough Hospitals

Royal Devon and Exeter Healthcare

Stockport

Royal Marsden

The trusts that dropped out

North Tees and Hartlepool

Rotherham General Hospitals