What is a ‘new FT’?

It is unclear from the plan whether a ‘new FT’ is a new legal form of NHS provider organisation, or is a status given to the best performing NHS trusts and FTs. The use of language around ‘authorisation’ for new FTs suggests the former, but the latter is also possible, for example via taking a separate regulatory and oversight approach to providers with that status. How current NHS trusts can access ‘new FT’ status will also need to be determined, as the existing restrictions on borrowing and retention of surpluses could be lifted in practice – without changing the law – with agreement from the Secretary of State. On all these matters, it will ultimately be for ministers to decide.  

The removal of the requirement to have a council of governors, and the removal of councils’ powers from statute that will be required to enact that, in practice changes the existing FT model to such an extent that it would create a new one. However the 10YHP does not draw a link between the removal of governors and trusts being awarded ‘new FT’ status based on performance, or how ‘new FTs’’ autonomy will be safeguarded. 

As the aspirations of the 10YHP are translated into policy, it will be necessary to articulate the distinct purpose of ‘new FT’ as a status. It will be important to establish how this complements and aligns with existing processes such as routine oversight and regulation under the NHS Oversight Framework, which also enable NHSE and DHSC to enhance or reduce oversight and award or deny financial freedoms.