The foundation trust sector must be more collaborative in order to make the most of a restrictive financial environment, the chief executive of the country’s newest FT has said.

Bradford District Care FT chief executive Simon Large also told HSJ that his organisation’s “identity” must change as FTs are now less able to produce and reinvest financial surpluses.

The provider was authorised by Monitor last month on the condition that it provided assurance of the performance of its quality and safety board subcommittees.

Large Simon

The FT brand has changed over the years, Simon Large said

Mr Large said he is in talks with neighbouring FTs to create an alliance able to take on the provision of whole care pathways by creating an “accountable care system”.

On what being an FT means, Mr Large said: “The FT brand has changed over the years. I don’t think an FT has the same goals in the current economic environment as it would have had 10 years ago.

“But the whole notion that you have financial freedoms around how you might choose to invest your surpluses and create surpluses through the generation of business is part of a bygone era now.”

He added: “The idea of an FT being a much more competitive beast [than a trust] I think is probably changing.

“We are now in an era much more of collaboration and joint working to find solutions that require very creative and different uses of the FT brand.

“However, I still think the FT comes with a credibility around its ability to manage its services independently.”

Describing Bradford District Care’s ambitions for the patch, Mr Large said that the alliance he envisioned would be a loose association of providers, probably including Airedale, and Bradford Teaching Hospitals FTs.

He said: “One of the things we are starting to do is think about where the provider, either us or us as part of a provider alliance, can take on the responsibility for a whole pathway of care, [including] some of the commissioning responsibilities.

“It’s got some similarities to an accountable care system, rather than a single accountable care organisation. It’s more a system approach where you might have a lead provider that subcontracts with other providers and managing across a whole pathway.”

Speaking about the provider’s journey to FT status, Mr Large said: “Because we entered the FT process in 2012 we have had new hurdle after new hurdle.”

After being given the go ahead by the NHS Trust Development Authority to go through the FT pipeline in 2012, the process effectively ground to a halt.

He said: “We were finding it harder and harder to produce a five year plan that stacked up. Each year that went by we were having to refresh our plan and still make it stack up in what was a deteriorating economic situation.”

“In effect, for three years, we have been through new hurdle after new hurdle. That takes up a lot of time, energy and focus for the trust board. For me it was a tortuously long period of time.”

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