22 February 2008
Monitor has issued a 'hands-off' warning to the Department of Health and told NHS foundation trusts they must rethink their relationships with their strategic health authorities.
The regulator's chair, William Moyes, has written to foundation chairs and chief executives, as well as NHS chief executive David Nicholson, reiterating foundation trusts' independence.
In the letters, seen by Public Finance, he fears correspondence from the DoH has over-stepped the line between the acceptable – setting targets for foundations – and the unacceptable, mandating how they achieve those targets.
The regulator believes that as more foundations are established, the relationship with the DoH and SHAs must be made clearer. Some foundation trusts complain their SHAs still try to manage their performance, even though they are autonomous bodies.
Moyes warned: 'It is important to remember that you are in different ways accountable for the performance of your foundation trust. If problems arise, it will be no excuse to say you were simply operating within a framework defined by the Department of Health or the SHA. '
Problems arose over the DoH's correspondence on improving hospital hygiene, which was sent in the wake of the Healthcare Commission's report on infection control at Maidstone and Tunbridge Wells Hospital.
Monitor agreed hygiene should be a priority but it objected to foundation trusts being told to deep clean wards, for example.
Nicholson tried to play down the row. 'I fully support the autonomy of NHS foundation trusts and the role of Monitor as their regulator,' he said.
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