Foundation Trust FAQs

Q1. What is a Foundation Trust?

  • Foundation Trusts are independent membership organisations but remain part of the National Health Service. Foundation Trust services remain subject to NHS standards and they continue to be monitored by the Care Quality Commission.
  • Foundation Trusts, while remaining part of the NHS, are however able to act independently. With this independence also comes freedoms and responsibilities which subject a Foundation Trust to new accountability arrangements.
  • Foundation Trusts are established as separate legal bodies, public benefit corporations, which become free from central government control but subject to regulation by ‘Monitor’ which is the national regulator for Foundation Trusts.
  • Foundation Trusts have different reporting arrangements that make them accountable to the local communities which they serve.
  • Foundation Trusts are membership organisations, and the members, who include patients, their carers, staff and the wider general public, will have an increased role in determining the future of service provision.
  • Foundation Trusts have to demonstrate that they are able to manage their spending within agreed budgeted levels and have to demonstrate a thorough competence of wider financial management. In return, Foundation Trusts enjoy access to a more flexible financial regime, which, in turn enables them to be more responsive, giving them the:
    –        Ability to raise finance to purchase new buildings and equipment.
    –        Power to reinvest generated surpluses into new service developments.

More information on Foundation Trusts can be found at: and


Q2. Why did we become a Foundation Trust?

  • We want people to be more involved in shaping the services we provide
  • We want to be able to meet patient needs more quickly
  • We want our staff to become more involved in influencing our plans
  • We want to develop our partnership working

Q3. How does the Governance of RJAH Foundation Trust Work?


Members are local people, service users, carers and staff who collectively have a stake in the Foundation Trust. They can be involved at different levels. They give views on the Trust and its services and can elect and be elected as Governors. Members can also apply for vacant Non-Executive Director posts on the Board of Directors.

Council of Governors

Governors are individuals elected by the members nominated by our partner organisations. Governors advise on the strategic direction of the Trust and its services, appoint the Chair and Non-Executive Directors and approve the appointment of other members of the Board of Directors. The Council of Governors and the Board of Directors is chaired by the Chair of the Foundation Trust.

Board of Directors

Executive and Non-Executive Directors are appointed for their expertise to deliver strategy and run the day to day operations of the Trust. Directors are accountable for meeting national standards, performance targets and financial requirements. They will report to the members through the Council of Governors.


Q4. What does being a member involve?

You can have as much or as little involvement as you want. Is it free to join and as a member you will receive information about our services and our plans. You will be invited to events and meetings during the year, asked for your views on how services should develop, be eligible to vote in elections for the Council of Governors, or stand for election yourself. It is really up to you how much involvement you have.

Q5. What is the total number of members RJAH has recruited so far and what are the projections for the future?

So far we recruited 4465, (2011-2012) members and look to grow that by 10% each year to 5455, (2014-2015). 

Q6. How does that number compare with other Foundation Trusts?

It is very similar for small specialist Trusts like RJAH Orthopaedic Hospital.