New Foundations: the future of NHS trust providers

27 April 2010
In February 2010 the Royal College of Nursing surveyed members in England working in NHS foundation trusts. The aim was to build a snapshot picture of our members’ opinions about their trusts to help us understand how foundation trusts are performing in the following areas: engaging with patients, local communities and staff to design services and shape strategy: using their greater independence; and helping nurses to deliver the highest quality of care. This briefing contains the results of this survey.

Key recommendations

  • Foundation trusts need to improve staff membership and engagement strategies. Simply opting staff in to membership is not enough.
  • Governors in foundation trusts need to be independent and have the skills to both challenge and support the work of the board of directors.
  • The RCN accepts that there may be some need for parts of board of director meetings to take place in private. However, we believe that the majority of business could and should be discussed in an environment in which members are not consistently excluded.
  • Nurse/midwife directors on the board should be championing quality throughout the trust. RCN supports the principle that there should be no more than two levels between sisters and charge nurses on the ward and the director of nursing. This will help to ensure a 'ward to board' culture in the management of the trust, in which openness, quality and patient safety are prioritised.

If you have any comments or wish to contribute further, please email

Page last updated - 21/08/2015