Accountability of foundation trusts in the English NHS: views of directors and governors

Dixon, Anna; Storey, John and Alvarez Rosete, Arturo (2010). Accountability of foundation trusts in the English NHS: views of directors and governors. Journal of Health Services Research & Policy, 15(2) pp. 82–89.

DOI: https://doi.org/10.1258/jhsrp.2009.009078

Abstract

The objectives of this article are to map and describe the formal accountability relationships of Foundation Trusts (FTs) and to probe the interpretations of these relationships by the key actors. The research methods included documentary analysis and interviews with Chief Executives, Chairs, Directors and Governors in six Acute Trusts and two Strategic Health Authorities. It was found that athough vertical accountability to DH (via SHAs) has, in formal terms, been removed, some FTs continue to be held accountable by SHAs (albeit informally). Directors of FTs perceive strong accountable to Monitor, particularly for financial performance, but there is some confusion about where accountability for quality of care rests. Horizontal lines of accountability to the local population through LINks and OSCs remain weak. Contrary to the major policy objectives of giving greater autonomy to FTs and making them more accountable to the local population, FTs continue to look up rather than down. The accountability of FTs needs to be simplified, clarified and strengthened.

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