The challenges are piling up for trusts yet to clear the hurdle of achieving foundation status

Last week HSJ revealed that the regulator’s board minutes exposed an “apparent lack of appetite” for securing foundation status.

This week, the departure of another chief executive means several of the 95 trusts still to be authorised are without their lead manager.

And the public sector funding squeeze means the spectre of the financial bar for new FTs being raised even higher now looms over the process.

The weaknesses Monitor has identified in some trusts are more to do with managerial competence than the higher skills demanded of FTs.

Some simply do not understand what is going on within their walls. Others have wasted time and money constructing business plans that are a chimera, put together by boards judged incapable of meeting the challenge of autonomy.

‘The application process for foundation status is succeeding in flushing out institutions with weak leadership’

The revelations do at least demonstrate the application process for foundation status is succeeding in flushing out institutions with weak leadership, management or governance. However, Monitor would do well to provide evidence that the changes to its procedures in the light of the scandal at Mid Staffordshire foundation trust will achieve the aim of ensuring it is now impossible for a rogue institution to achieve foundation status.

Meanwhile any vacancies are a severe test of the NHS talent pool. The difficulties of attracting outside talent are immense. NHS London believes chief executives arriving from other sectors take up to four years to orientate themselves, which is not much help to a trust wanting to submit its foundation application by the 2010 deadline.

For those inside the service, some take a masochistic pleasure in seeking out jobs at trusts in the mire, but for many, taking senior posts at trusts with financial difficulties such as Barts and the London is even less appealing as the public sector recession tightens its grip.