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.
19-693: The Royal Cornwall Hospitals NHS Trust is an NHS trust which runs West Cornwall Hospital , St Michael's Hospital , Royal Cornwall Hospital , and St Austell Hospital - Penrice Birthing Unit, in Cornwall , England. The trust was established as the Royal Cornwall Hospitals and West Cornwall Hospital NHS Trust on 1 November 1991, and became operational on 1 April 1992. It changed its name to its current name soon after on 9 June 1992. In June 2013, Martin Watts resigned from his post as Chair of
38-649: 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 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
57-488: 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 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
76-423: 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 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
95-490: 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 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
114-521: 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 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
133-678: The Better Care Fund with Cornwall Council , the number of homecare providers was increased from 20 to 40 and homecare workers were paid the National Living Wage . In the twelve months to September 2018, the trust was at OPEL level 4 – a major crisis requiring external help – for 134 days, the worst in England, with operations repeatedly cancelled. In 2018, the CQC rated the trust as requiring improvement. When Scan4Safety
152-762: The Trust after external investigations into two separate complaints were upheld. In October 2013, one of the trust's governors complained that the health and social care system in the county was dysfunctional because some elements of health care were no longer part of the NHS, but provided by what were "essentially private contractors". Community health services in the county are now provided by Peninsula Community Health The trust's plans to switch up to 450 jobs in catering, housekeeping, cleaning, portering, waste and switchboard functions to private companies were attacked by local Labour Party candidates in December 2013. In January 2019,
171-436: 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 the role of district health authorities and local authorities by changing their internal structure, so that local authority departments assess
190-405: The community and the hospital trusts are generally planning to follow these initiatives. Foundation trust status may be applied for by 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
209-464: The interim chief executive announced his resignation. The human resources director, company secretary, the interim chief operating officer and the interim director of financial recovery are also leaving. The Care Quality Commission (CQC) inspected the hospital in June 2015 and rated safety in medical care and the accident and emergency department as “inadequate”. In the last quarter of 2015, it had one of
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#1732791411283228-416: 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 a residential home setting. It established GP Fundholding . Finally,
247-497: The remaining NHS trusts to become foundation trusts, saying "We are frankly kidding ourselves if we think the non-FTs are going to pass 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
266-532: The trust be placed in special measures . In 2019, it was fined a total of £16,250 for 13 separate breaches of the NHS statutory duty of candour after it failed to notify the patient or their family of the facts available in a safety investigation as soon as reasonably possible. Performance against the four-hour target improved from 56.6% in February 2018 to 94.1% in April. Sixty care home beds were purchased through
285-607: The trust decided to move elective orthopaedic work out of Treliske to St Michael's Hospital in Hayle, in order to protect the waiting list from the pressure of emergencies. This made room for a frailty unit at Treliske. The trust was one of the biggest beneficiaries of Boris Johnson 's announcement of capital funding for the NHS in August 2019, with an allocation of £100 million for a new women's and children's hospital in Truro. The trust
304-587: The worst performances of any hospital in England against the four-hour waiting target. In March 2016, the trust was rated as having a poor reporting culture in the Learning from Mistakes League . In October 2017, the CQC reported that patients were waiting too long for treatment and suffering harm as a result. There were long delays in cardiology and ophthalmology and unacceptable levels of operations canceled. There were shortages of midwives, and midwives were insufficiently equipped and trained They recommended that
323-560: 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 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
342-581: Was introduced in its pharmacies the trust managed to reduce dispensing errors by 76%. In 2022 89 patients waited in A&;E longer than 48 hours for a bed in April and May with 865 patients waited in the ED longer than 24 hours in the same period. NHS trust NHS trusts were established under the National Health Service and Community Care Act 1990 and were set up in five waves. Each one
361-482: Was one of 26 responsible for half of the national growth in patients waiting more than four hours in accident and emergency over the 2014/5 winter. The trust established a cleaning contract with Mitie in 2014 worth £90M over seven years. Sick pay cost £1.2M in its first eight months compared with £280,000 for the NHS in the previous financial year. UNISON blamed the rise on staff stress which it claimed had been caused by mistakes on pay. In October 2015, Bill Shields,
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