Governors at the 141 National Health Service foundation trusts are currently responsible for appointing their trusts’ chairs and non-executive directors. Subject to the will of Parliament, the Health Bill will transfer this power to my Rt. Hon. Friend, the Secretary of State for Health and Social Care. We will publish our intended approach to making these appointments in due course which will support foundation trusts to plan and make arrangements in good time ahead of the transfer being made.

As set out in our 10-Year Health Plan, while governors have provided helpful advice and oversight for some foundation trusts, we expect the next generation of foundation trusts to put in place more responsive and flexible arrangements for drawing on patient, staff and stakeholder insight. Rather than a one-size-fits-all model, providers should develop engagement arrangements that reflect their local populations, geographies and healthcare needs.

Until such time as the Health Bill receives Royal Assent, the statutory requirements for councils of governors (CoGs) remain. All National Health Service foundation trusts (FTs) will be expected to have put in place effective arrangements for community engagement by the time the bill provisions to remove CoGs have commenced.

To ensure the effectiveness of these arrangements, they will be tested as part of ongoing assurance processes, including provider capability assessments, Care Quality Commission well-led assessments, and the assessment process for advanced foundation trust status.

If arrangements are found to be ineffective, there are a range of escalation approaches available. The appropriate intervention would depend on the circumstances and whether there were wider failures at the FT, but it could involve finding the trust in breach of the conditions of its provider licence and requiring the FT to develop and deliver a plan to address the issue.

The Department has published impact assessments for the Health Bill, which include an assessment of reform to the foundation trust model. This is available at the following link:

https://publications.parliament.uk/pa/bills/cbill/59-02/0009/ia_Structural_measures_to_ICBs.pdf

Until such time as the Health Bill receives Royal Assent, the statutory requirements for councils of governors (CoGs) remain. All National Health Service foundation trusts (FTs) will be expected to have put in place effective arrangements for community engagement by the time the bill provisions to remove CoGs have commenced.

To ensure the effectiveness of these arrangements, they will be tested as part of ongoing assurance processes, including provider capability assessments, Care Quality Commission well-led assessments, and the assessment process for advanced foundation trust status.

If arrangements are found to be ineffective, there are a range of escalation approaches available. The appropriate intervention would depend on the circumstances and whether there were wider failures at the FT, but it could involve finding the trust in breach of the conditions of its provider licence and requiring the FT to develop and deliver a plan to address the issue.

The Department has published impact assessments for the Health Bill, which include an assessment of reform to the foundation trust model. This is available at the following link:

https://publications.parliament.uk/pa/bills/cbill/59-02/0009/ia_Structural_measures_to_ICBs.pdf

The report will be considered as part of the wider work underway on future engagement models.

The removal of councils of governors from National Health Service foundation trusts forms part of the wider 10-Year Health Plan’s aim to ensure hospitals put patient experiences and outcomes at the heart of their decision-making.

While governors have provided helpful advice and oversight for some foundation trusts, we now need to move to a more dynamic model, drawing on patient, staff, and stakeholder insight.

We do not hold a comprehensive breakdown of National Health Service foundation trusts (FTs) borrowing from commercial lenders, so it is not possible to answer the specific question asked.

However, the Department provides financing for FTs in the form of Public Dividend Capital at 3.5% dividend rate and loans at interest rates at below market rates.

The lower costs and lower risks, for example terms relating to default of commercial borrowing, of obtaining finance from the Department has meant that commercial borrowing has not been typically needed.

The removal of the councils of governors from National Health Service foundation trusts (FTs) forms part of the wider aim of the 10-Year Health Plan to ensure that hospitals put patient experiences and outcomes at the heart of their decision-making. The regulatory functions supporting oversight of the governance of FTs are underpinned by the NHS provider licence which will continue.

While governors elected by the public and other stakeholders have provided helpful advice and oversight for some FTs, we now need to move to a more dynamic model, drawing on patient, staff, and stakeholder insight. For example, approaches to engagement that better reflect local demographics and geography rather than a ‘one size fits all’ governor model, as well as supporting an increasing focus on the outcomes of the engagement, including the evidence that local people are involved in key decisions about how care is provided and their voices are listened to.

The removal of the councils of governors from National Health Service foundation trusts (FTs) forms part of the wider aim of the 10-Year Health Plan to ensure that hospitals put patient experiences and outcomes at the heart of their decision-making. The regulatory functions supporting oversight of the governance of FTs are underpinned by the NHS provider licence which will continue.

While governors elected by the public and other stakeholders have provided helpful advice and oversight for some FTs, we now need to move to a more dynamic model, drawing on patient, staff, and stakeholder insight. For example, approaches to engagement that better reflect local demographics and geography rather than a ‘one size fits all’ governor model, as well as supporting an increasing focus on the outcomes of the engagement, including the evidence that local people are involved in key decisions about how care is provided and their voices are listened to.

The Council of Governors at National Health Service foundation trusts have a range of statutory roles and powers including representing the views of local populations, staff, and other stakeholders to the foundation trusts’ board.

The removal of the Council of Governors forms part of the wider 10-Year Health Plan’s aim to ensure that hospitals put patient experiences and outcomes at the heart of their decision-making. While governors have provided helpful advice and oversight for some foundation trusts, we now need to move to a more dynamic model of drawing on patient, staff, and stakeholder insight.

The removal of the Council of Governors will require primary legislation which the Government will bring forward when Parliamentary time allows.

The Council of Governors at National Health Service foundation trusts have a range of statutory roles and powers including representing the views of local populations, staff, and other stakeholders to the foundation trusts’ board.

The removal of the Council of Governors forms part of the wider 10-Year Health Plan’s aim to ensure that hospitals put patient experiences and outcomes at the heart of their decision-making. While governors have provided helpful advice and oversight for some foundation trusts, we now need to move to a more dynamic model of drawing on patient, staff, and stakeholder insight.

The removal of the Council of Governors will require primary legislation which the Government will bring forward when Parliamentary time allows.