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Friday 21st October 2016

NHS foundation trusts forecast

22nd August 2007

NHS foundation trusts forecast year of further improvement as regulator encourages greater investment in services.

Monitor, the independent regulator, has published its review of NHS foundation trusts’ annual plans for 2007-08 which reveals:

  • capital expenditure of £921 million on projects which will directly benefit patients and staff; 
  • significant increase in their membership base to strengthen local accountability, with total membershipexpected to approach 1.5 million by the end of the financial year; 
  • a planned combined surplus of £198 million (before exceptional items) for the year; 
  • further efficiency savings demonstrated by an improved operating margin of 6.8% compared with 6.6% in 2006-07.

The report calls for those boards of NHS foundation trusts failing to meet certain of the government’s healthcare targets to identify how surpluses and borrowing freedoms can be used to address this underperformance.

Monitor is also encouraging boards of NHS foundation trusts to consider other investment opportunities, including developing innovative service delivery and investing in high-calibre staff to drive further improvements in patient care and implement longer term strategic plans.
The review makes it clear that uncertainty about the plans of those who commission health services will continue to make foundation trusts hesitant about investing in new services.

Writing in the report’s foreword, Bill Moyes, Chair of Monitor says:

“NHS foundation trusts have the freedom and opportunity to use their cash reserves and access to borrowing to deliver better services for patients. Their plans for 2007-08 show that they expect to increase capital expenditure, creating better environments for patients and staff. However, historically, NHS foundation trusts have underspent on their planned investment programmes and uncertainty about commissioners’ plans will continue to influence decision making and may act as a brake on investment.?

The report also suggests that independent review of board self-certification may be introduced, if boards are not able to demonstrate that the information on which they base their plans, and specifically their governance declarations, is robust. This is based on a number of situations where NHS foundation trust boards have certified to their regulator that they will meet healthcare targets but then failed to do so subsequently.

The report NHS Foundation Trusts: Annual Plans 2007-08 is available to download from the Monitor website.


The following examples of planned capital expenditure were identified in NHS foundation trusts’ annual plans for 2007-08.

  • Sheffield Teaching Hospitals NHS Foundation Trust is expanding the Critical Care Unit at its Northern General Hospital site. The planned expenditure of £16.8 million in 2007-08 is part of a £21.3 million redevelopment, which will be increase total capacity at the unit to 35 beds and ensure the trust can meet its projected demand for 2009-10
  • Homerton University Hospital NHS Foundation Trust is building a new £10 million perinatal centre. Completion is planned for 2009-10. The centre will add capacity for 768 neonatal bed days and 482 obstetrics admissions. 
  • A new children’s centre is planned at Chesterfield Royal Hospital NHS Foundation Trust, which will have capacity to treat approximately 30,000 additional patients per annum. The new centre will bring children's services into a new build on the main hospital site, replacing peripheral properties across Chesterfield. The overall cost of the project £4.9 million and is expected to be completed in 2008-09.

For media enquiries contact: Michael Moruzzi on 020 7340 2438 or 0779 5962933.

Monitor authorises and regulates NHS foundation trusts ensuring they are well-managed and financially strong in order to deliver high quality healthcare for patients. 

Monitor was established in January 2004. It is independent of government and accountable to Parliament. Monitor’s functions and powers are set out in the National Health Service Act 2006.


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