Trusts are being asked to re-submit their target dates for attaining foundation status amid new evidence that significant numbers will fail to complete the process by the original deadline.
The NHS Trust Development Authority’s move effectively acknowledges that many organisations are unable to honour their previous commitments to the Department of Health. It comes as HSJ research reveals the growing number of trusts experiencing delays in completing the “foundation trust pipeline”.
In September 2011, trust chief executives had to sign “tripartite formal agreements” with the DH and strategic health authorities committing them to a timetable for becoming foundation trusts.
Many have already slipped against these dates and been “escalated” to the DH or their SHA for performance management. Some trusts saw changes to their boards following escalation.
The Trust Development Authority, which is responsible for all non-foundation trusts and started work in October, has now effectively superseded the tripartite formal agreements process by asking boards to say whether they can still achieve the date they gave in 2011. The new date declaration is part of the 2013-14 operating plans trusts must submit to the authority by 25 January.
If trusts declare they cannot meet the date they gave in 2011 they must give a new commitment.
The DH and former health secretary Andrew Lansley have previously threatened to sack boards which fall behind in the authorisation process.
Trust Development Authority chief executive David Flory told HSJ in October he was still committed to Mr Lansley’s target of an all-foundation trust sector by April 2014 in all but “a handful” of cases.
The authority has taken on powers formerly held by the DH to appoint or remove trust boards and to allocate capital to trusts.
A spokesman for the authority said it expected only a “small shift” in trusts’ target dates for becoming foundations.
But HSJ research shows significant numbers of trusts are failing to hit the application dates they gave in their tripartite formal agreements.
Only two of the 18 trusts whose agreements committed them to making their initial application to the DH between 1 October 2012 and Tuesday have achieved the target.
One senior consultant working with the non-foundation trust sector told HSJ there were “numerous examples” of trusts having to set a date in the tripartite formal agreement that had “not been realistic” and said many organisations had seen their target date put back more than once.
The authority was not able to confirm how many trusts had been escalated or missed application dates as HSJ went to press.
A spokesman said it would be issuing “further guidance” on escalation and approvals by March.
HSJ revealed in July that 16 trusts were escalated for delays to their applications.
The 2013-14 operating plan questionnaires, issued by the authority before Christmas, could signal another wave of mergers.
It asks trusts if they now “intend to pursue an alternative plan” to becoming an FT in their own right.
The tripartite formal agreement process, led by then DH head of provider development Ian Dalton, saw many trusts declare they could not make a standalone application for foundation status and would have to merge with or be taken over by another organisation.
The authority has so far approved 15 trusts to be passed on to the Monitor stage of the approval process, including five community foundation trusts.
Monitor authorised the West Midlands Ambulance Service Trust at the end of 2012 but turned down applications from Leicestershire Partnership Trust and East of England Ambulance Service Trust.
These have been deferred for six and 12 months respectively.