A review by foundation trust regulator Monitor reveals the trusts have some way to go before they are fully accountable organisations.

A survey of foundation trust governors found many wanted more support from the trusts to hold them properly to account.

Governors have a statutory duty to oversee foundation trusts' audit, appointments, pay, membership and business planning. Just over half of the 1,328 governors surveyed had been involved in at least one of these functions.

In its commentary on the survey, Monitor said it was important foundation trust chairs addressed the fact that a significant proportion of governors said they were not happy with the level of contact they had with the executive board.

However, four in five governors said they were clear about their roles and responsibilities. Twelve per cent said they were not clear but Monitor said that included those who were new to the role.

Foundation Trust Network director Sue Slipman said its own survey last year found high levels of active participation among longer-standing governors, with almost 90 per cent contributing to business plans.

Monitor executive chair Bill Moyes said: "The legislation that created foundation trusts provides governors with genuine powers. It is therefore important that governors are using these powers effectively and that is why we intend to produce more specific guidance for governors in this area."

In January Gordon Brown used his first prime ministerial speech on the NHS to set a target to treble foundation trust membership from one million to three million by 2012. Members are supposed to assert local accountability over foundations and are represented at the management level through their council of governors.

Ms Slipman said that now some primary care trusts were expressing an interest in establishing memberships, it was important that organisations co-operated in their recruitment campaigns. Competition for members risked confusing the public about how they could be involved in the running of their local health services, she said.

Governors' views

53% said the trust was good at communicating to the community what it was doing

24% said their meetings were only productive sometimes

16% are dissatisfied with their contact with the executive board

12% said they are not clear about their roles and responsibilities

3% said the trust chair was not doing a good job

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