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Governance

  • Last modified date:
    9 January 2009

The Health and Social Care Act 2003 sets out the minimum legislative requirements for the governance of NHS Foundation Trusts. Within this framework NHS Foundation Trusts have the freedom of local flexibility to tailor their governance arrangements to the individual circumstances of their community and health economy, whilst reflecting the range of diverse relationships with patients, the local community and other stakeholders.

Membership

NHS Foundation Trusts have a duty to engage with local communities and encourage local people to become members of the organisation. Legislation states that NHS Foundation Trusts must take steps to ensure that the membership is representative of the communities they serve. Eligibility criteria for membership varies between NHS Foundation Trusts depending on their local circumstances. As a minimum, membership of an NHS Foundation Trust will be open to:

  • people who live in the local area
  • staff
  • if an NHS Foundation Trust's constitution provides for it, people who live outside that area but have been patients or carers of patients treated at one of the NHS Foundation Trust's hospitals; and people who exercise functions for the NHS Foundation Trust but who are not employed by the organisation (e.g. staff employed in a PFI venture.)

The members elect a Board of Governors.

Boards

There are two Boards in an NHS Foundation Trust:

  • Board of Governors
  • Board of Directors

The Chair of the NHS Foundation Trust is both the Chair on the Board of Governors and the Board of Directors. This ensures that views from Governors are considered by the Directors. Governors are responsible for appointing the Chairman and non-executive directors of the Board of Directors.

The Board of Governors will not be involved in matters of day to day management such as setting budgets, staff pay and other operational matters - that is a matter for Board of Directors. The Board of Directors carries responsibility for ensuring the NHS Foundation Trust delivers the terms of authorisation agreed by the Monitor.

Board of Governors

The Board of Governors represent the interests of the members and partner organisations in the local health economy in the governance of the NHS Foundation Trust, and for sharing information about key decisions with their membership community.

The main function of the Board of Governors will be to work with the Board of Directors to ensure that the NHS Foundation Trust acts in a way that is consistent with its terms of authorisation and to help set the strategic direction.

Legislation provides for each NHS Foundation Trust to decide on the size and shape of its Board of Governors in the light of their local circumstances, within certain minimum parameters set out in legislation, as indicated below:

  • overall majority of places must be made up of representatives elected from public and patient membership
  • at least three staff governors elected from the staff membership
  • at least one local authority governor, one primary care trust governor and where applicable at least one university governor, all via nomination. 

Over and above those minimum requirements there can be as many other governors as an individual NHS Foundation Trust sees fit provided there are more public governors than all the other governors put together. A person cannot be a Governor of an NHS Foundation Trust if they are bankrupt or have served a prison sentence of three months or more during the last five years. Governors are eligible to serve for a term of up to three years and to stand for re-election.

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