Monitor to beef up foundation trust approval process

28 Jan 16

Health service watchdog Monitor has announced it is to tighten its processes for awarding hospitals foundation trust status after a review called on it to strengthen its approach, including to financial governance.

An independent review was carried out following the decision to grant St George’s University Hospitals foundation status despite deficit forecasts.

The examination, carried out by Health Group Internal Audit, found no breakdown in Monitor’s provider appraisal process.

However, it highlighted a number of areas where improvements could be made. These included strengthening its approach to financial governance by increasing scrutiny of financial reporting procedures and of working capital.

The regulator was also urged to ensure accountants have a full and common understanding of the breadth and depth of the work required by them on these reviews, and to seek third party assurances where there were delays in the authorisation of a trust.

Miranda Carter, Monitor’s executive director of provider appraisal, said these recommendations had been accepted. The changes would ensure Monitor’s processes mirror the increased financial risk the health sector faced, which has seen rising provider deficits.

“It also enhances ability to identify risks in applicant trusts while also providing greater clarity to reporting accountants on our expectations of what their work should cover,” she added.

“We will continue to monitor the performance of our processes and will make further changes if necessary to ensure they continue to be robust and fit for purpose.”

Last October, NHS England chief executive Simon Stevens said the service should “call time” on the foundation trust pipeline. He said “we are frankly kidding ourselves” in believing trusts could ever meet the benchmarks in the current climate.

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