An NHS trust is an organisational unit within the National Health Services of England and Wales , generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several trusts involved in the different aspects of providing healthcare to the local population. As of April 2020 , there were altogether 217 trusts, and they employ around 800,000 of the NHS's 1.2 million staff.
19-675: North Middlesex University Hospital NHS Trust is an NHS trust which runs North Middlesex University Hospital in Edmonton, London and community services in Enfield. The trust serves more than 350,000 people living in the London boroughs of Enfield and Haringey , as well as the nearby boroughs of Barnet and Waltham Forest . It works closely with the Royal Free London NHS Foundation Trust and although
38-732: A wide range of adult and children’s community services in Enfield. Dr Nnenna Osuji took over as Chief Executive in July 2021 following the departure of Maria Kane OBE in April 2021. Elizabeth McManus, who was chief executive before Maria Kane, resigned in 2017. The trust has had serious problems with its accident and emergency service failing to meet the Four Hour Emergency Target since 2016, and so had difficulty recruiting senior staff. The General Medical Council and Health Education England considered removing junior doctors from
57-479: A £29 million deficit. It has considered appealing to Tottenham Hotspur , with which it has an established relationship, for financial help. It was suggested that a 20p surcharge on food, drink and match programmes for fans attending home matches could raise around £300,000 a year. There were 81 serious incidents reported by the trust in 2016-17 and 88 in 2017-18. Healthwatch Enfield reported in March 2018 that 75% of
76-645: Is nationally recognised as a leading centre for these diseases. The trust was established as the North Middlesex Hospital NHS Trust on 17 December 1990, and became operational on 1 April 1991. It took its current name on 31 July 2001. On 1 April 2023, the Trust welcomed over 600 new staff following the transfer of Enfield Community Services for a neighbouring Trust; the additional teams include district nurses, community matrons, community physiotherapists, psychologists and many more across
95-518: The National Health Service and Community Care Act 1990 and were set up in five waves. Each one was established by a statutory instrument . NHS trusts are not trusts in the legal sense but are in effect public sector corporations . Each trust is headed by a board consisting of executive and non-executive directors , and is chaired by a non-executive director. There were about 2,200 non-executives across 470 organisations in
114-515: The A&;E. It had the poorest A&E waiting times in London with only seven of the 15 consultant posts and seven of 13 middle-grade emergency posts filled. In October 2018 it succeeded in recruiting a substantive chief operating officer from Barking, Havering and Redbridge University Hospitals NHS Trust and Emma Whicher, NHS Improvement ’s London medical director to be its medical director. The Care Quality Commission reported some improvements in
133-920: The Care Quality Commission praised the continuing improvements in the Accident and Emergency department at North Middlesex University Hospital in an inspection report. England's Chief Inspector of Hospitals, Professor Ted Baker, said: "Care provided at the North Middlesex University Hospital emergency department has continued to improve and I am pleased to see it". The Care Quality Commission confirmed these sustained improvements in its inspection report in October 2022, where it said that emergency department staff are "skilled, responsive and kind" despite ongoing pressure. NHS trust NHS trusts were established under
152-619: The NHS in England in 2015. Non-executive directors are recruited by open advertisement. All trusts ( foundation trusts and those which have yet to reach foundation trust status) are regulated by NHS England and the Care Quality Commission . Board members are, from November 2014, subject to a fit and proper person test . All trust boards are required to have an audit committee consisting only of non-executive directors, on which
171-528: The above categories of NHS trust. Successive governments have announced that all NHS trusts should become foundation trusts, and deadlines have been set for this transformation, which have repeatedly been missed. Several special health authorities , organised on a national basis, deal with NHS-wide issues. An example is NHS Blood and Transplant . National Health Service and Community Care Act 1990 The National Health Service and Community Care Act 1990 (c. 19 ) introduced an internal market into
190-471: The accident and emergency department after an inspection in September 2016 after earlier rating it as inadequate, but still noted nurse staffing shortages, inadequate checks on agency staff and a poor culture, especially in the maternity unit. In December 2017 it was reported that during two weeks of data collection it had not had one day with any of its 460 beds unoccupied. It ending the year 2017/8 with
209-570: The board voted against full membership of the Royal Free London group in October 2018, plans are again on the table for a full merger between the trusts as soon as from summer 2024. The trust provides a full range of adult, elderly and children's services across medical and surgical disciplines. Its specialist services include stroke, HIV/AIDS, cardiology (including heart failure care), haematology, diabetes, sleep studies, fertility and orthopaedics. Its sickle cell and thalassaemia department
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#1732798684694228-515: The chair may not sit. This committee is entrusted not only with the supervision of financial audit , but of systems of corporate governance within the trust. Hospital board members have a duty to act on signals of poor performance on quality and safety data, and yet many of the papers presented to them have been found to be lacking good data visualisations. The High Court of Justice decided in December 2019 that NHS trusts were not charities for
247-498: The kinds of criteria that have been set by Monitor ." There are several types of NHS trusts: Over time the distinction between different types has eroded, and both hospital and mental health trusts have taken on responsibility for various community services. Sustainability and transformation plans all propose to move services out of hospitals into the community and the hospital trusts are generally planning to follow these initiatives. Foundation trust status may be applied for by
266-420: The patients who attended the A&E department had not attempted to make a GP appointment. The trust has a GP-led urgent care centre but many patients preferred the A&E department because of the availability of X-ray, CT and MRI scans and blood tests. Maria Kane said: “It’s clear that as a local health system we are not communicating well enough the range of alternatives and how to use them.” In February 2020
285-579: The purposes of the Local Government Finance Act 1988 , so they have to pay business rates at the full rate. A study by the University of Exeter in 2020 found that in 70 out of the 213 trusts all the board members were white. Overall BAME representation at board level was 8.9%. Medical directors of BAME ethnicity accounted for 19.4%, about the same as the overall percentage of BAME doctors. In September 2015 Jeremy Hunt
304-455: The results determine whether or not care or social services will be provided. This also ensures that the people giving the care follow a certain set of rules called the care value base. Local authority resources can be taken into account during the assessment process, but if it is deemed that services are required, those services must be provided by law: services cannot be withdrawn at a later date if resources become limited. The Act also split
323-489: The role of district health authorities and local authorities by changing their internal structure, so that local authority departments assess the needs of the local population and then purchase the necessary services from 'providers'. To become 'providers' in the internal market, health organisations became NHS trusts, competing with each other. Community care ensures that people in need of long-term care are now able to live either in their own home, with adequate support, or in
342-485: The supply of healthcare in the United Kingdom, making the state an 'enabler' rather than a supplier of health and social care provision. The Act states that it is a duty for local authorities to assess people for social care and support to ensure that people who need community care services or other types of support get the services they are entitled to. Patients have their needs and circumstances assessed and
361-402: Was reported as saying "I think we do have too many trusts as independent organisations" in a context where mergers between trusts and the establishment of chains of hospitals were being discussed. Subsequently Simon Stevens made it clear that he did not expect the remaining NHS trusts to become foundation trusts, saying "We are frankly kidding ourselves if we think the non-FTs are going to pass
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