Three-star rating alone will not secure foundation status

A three-star rating will not be enough to guarantee trusts foundation status, and aspiring candidates will face a further round of tough assessment to ensure their high performance is sustainable, HSJ has learned.

The extra hurdle has been put in place to deal with concerns about awarding foundation status to three-star trusts that subsequently slip back to two stars. Three stars are now considered necessary - but not sufficient - for foundation status, according to government sources.

This year's star ratings, now due to be published next week, are expected to show movement in both directions, with some threestar trusts dropping a star, while some zero-star trusts will gain one. But some zero trusts are still expected.

Details of the application and assessment process for aspiring foundation trusts are set to be released in the wake of the star-ratings, and will include timescales and the new criteria against which applicants will be assessed.

The rigorous assessment will include a detailed look at clinical quality, financial stability, quality of leadership and support from stakeholders in the local health community. The assessment is expected to be intensive and to focus on sustainability as well as current high performance.

Moves to ensure some degree of stability at would-be foundations will help allay fears expressed by the NHS Confederation that 'freedoms cannot come and go with annual assessment of performance, particularly where they relate to processes that have a timescale of more than one year' - such as foundations' proposed freedoms in capital borrowing and land sales.

Next week's announcements are expected to give some detail of the future shape of foundation trusts, though this will be subject to legislation.