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47-622: The Royal Free London NHS Foundation Trust (formerly the Royal Free Hampstead NHS Trust ) is an NHS foundation trust based in London, United Kingdom. It comprises Royal Free Hospital , Barnet Hospital , Chase Farm Hospital , as well as clinics run by the trust at Edgware Community Hospital, Finchley Memorial Hospital, and North Middlesex University Hospital . On 1 July 2014, the Barnet and Chase Farm Hospitals NHS Trust

94-542: A Mariah Carey tribute entitled 'I Don't Want A Christmas With Flu' – to promote the use of flu vaccinations. This was released on YouTube in November 2013 and also became a minor viral hit, enthusiastically supported by both Mariah Carey's fan pages on Facebook and even the Metro newspaper. In October 2013 the trust was said to have the lowest spend on in-patient's meals in the country at £4.15 per day. In November 2013 it

141-483: A YouTube video, 'Use This Handwash Style!', as part of a major new hand hygiene campaign. The video amended the lyrics to hit song Gangnam Style to remind staff about the seven stages of handwashing. Featuring over 300 members of staff from several departments washing their hands whilst dancing to the song, it became an unexpected online hit, averaging over a thousand views a day in the first week of its release. Staff from both hospital sites later made another music video –

188-402: A cap on the proportion of their income that can come from non-NHS treatments. It did not only apply to income derived from individual patients, it covered income from all non-NHS sources. This could include joint ventures to develop medical technologies, employers paying for counselling services or income from treating UK military personnel overseas. The Health and Social Care Act 2012 abolished

235-599: A few consultants at the Royal Free London NHS Trust and failures of the trust's management. In November 2020, the trust had 9,050 patients waiting 52 or more weeks for treatment on its elective waiting list, with another 10,542 who had waited 40–52 weeks. In partnership with UCL Medical School , the trust has major research activities and is a founding member of UCLPartners , the largest academic health science partnership in Europe, which in addition to

282-487: A link between the community and the board of directors. The size of the council of governors and its exact composition are determined by the constitution of the particular trust. Each trust adopts its own constitution subject to certain restrictions in legislation. These restrictions include that a majority of the council of governors must be elected governors and governors must be unpaid volunteers. Some trusts are more committed to co-operative principles and have even written

329-840: A new organisation – the NHS Trust Development Authority – was established by the Health and Social Care Act 2012 to supervise trusts which have not reached foundation status, of which there were 99 in April 2013, 47 of which were never expected to reach foundation status. The Health and Social Care Bill 2011 , overseen by Lansley, proposed that all NHS trusts become foundation trusts or part of an existing foundation trust by April 2014. The early foundation trusts were generally financially buoyant, but during 2013 and 2014 more faced financial difficulties. A foundation trust finance facility, managed by an advisory committee to

376-591: A shared services solution". By the end of 2013–14, foundation trusts collectively had built up cash reserves of £4.3 billion and it was suggested in the NHS Five Year Forward View that the government would "support" foundation trusts to spend this money "to help local service transformation". In response, the chief executive of the Foundation Trust Network, Chris Hopson, said: "The responsibility for these surpluses lies with

423-765: A time when many hospitals were merged for administrative and managerial reasons, in an attempt to create organisations with sufficient 'critical mass' to deal with a range of patient services. However rationalisation of services between the hospitals was slow to materialise, due in part to the PFI structure of Barnet Hospital, and in part to the reluctance of the local population and politicians to countenance concentration of specific services at only one location. The two trust hospitals treat over 500,000 patients per year; these come not only from Barnet and Enfield but also from East Harrow , South Hertfordshire , West Essex and Waltham Forest . Plans to rationalise some services between

470-773: A variety of tests, which have changed over time. In 2003 only trusts with three stars from the Commission for Health Improvement were eligible for foundation status. In that year Aintree Hospitals, Essex Rivers Healthcare, Newcastle upon Tyne Hospitals and Walsall Hospitals were all downgraded to two stars and so did not make the first wave of foundation trusts. Formerly referred to as foundation trust equivalent (FTe) instead of Equivalent Foundation Trusts , this designation applies only to trusts providing high secure psychiatric services, of which there are three: Nottinghamshire Healthcare NHS Trust , West London Mental Health NHS Trust and Mersey Care NHS Trust . These trusts abide by

517-432: Is a staff constituency, a patient constituency, and a "public member" constituency, consisting of members who are neither patients nor staff but live in a defined geographical area. In addition, there are governors appointed by bodies with whom the trust works in partnership. So, for example, appointments may be made by local councils, local medical schools, and local voluntary organisations. Governors are intended to act as

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564-585: Is described in Schedule 7 of the National Health Service Act 2006 , with the formal corporate form being called a "public benefit corporation". Each foundation trust has a council of governors. This is made up of elected governors and appointed governors. Elected governors are chosen by a secret postal ballot of the membership, which is open to the general public. The elections are usually held in separate constituencies. Typically there

611-606: Is the largest single-site teaching hospital in London and home to one of the three main campuses of UCL Medical School . The trust is also involved in the training of nurses, midwives and other clinical and non-clinical professionals. NHS foundation trust Alan Milburn 's trip in 2001 to the Hospital Universitario Fundación Alcorcón in Spain is thought to have been influential in developing ideas around foundation status. That hospital

658-533: The EMIS Web integrated clinical IT system. This enables the majority of patients to be sent home with written information on self care or referred to a pharmacy. The trust reported that vacancies had reached 1/6 of the nursing workforce in July 2015. In February 2016, it was expecting a deficit of £15m for the year 2015/16. A deficit of more than £95m was expected for the 2017/18 financial year. In September 2016,

705-679: The Rochdale Principles into their constitution; they aspire to work closely and in partnership with other mutual and local organisations. At first, foundation trusts were authorised and regulated by Monitor , a non-executive body under the Department of Health. Monitor was merged into NHS Improvement in 2016. The trade body for foundation trusts is NHS Providers , formerly known as the Foundation Trust Network, which has 95% of all acute, ambulance, community and mental health foundation trusts in its membership. A 2014 report by

752-553: The Socialist Health Association said that on the whole after 10 years, "Foundation Trusts [had]... not deepened in terms of democratic practice and participation". The independence of Foundation Trust governors was challenged in 2021 when the governors of Queen Victoria Hospital , a small specialist trust, called for a pause to plans for it to merge with University Hospitals Sussex NHS Foundation Trust . NHS Improvement were said to have effectively ordered

799-564: The Department of Health definition of a foundation trust, but the Secretary of State for Health maintains a direct line of communication and accountability with them because he or she has the responsibility to provide healthcare to patients who have been detained under the Mental Health Act , and have been judged to pose a grave and immediate danger to the public. Unlike full foundation trusts, governors have no statutory role, and

846-410: The Department of Health was promoting "A new type of NHS hospital". In 2011, the 116 trusts then in the pipeline to make applications were required to sign a formal agreement, with a deadline for the application to be made. Board members at a number of trusts which missed the deadline were sacked. It was accepted by Andrew Lansley that a number of trusts would never reach foundation trust status, and

893-484: The Department of Health, was established to process loans for capital developments, but during 2014 applications were made by trusts which had trouble paying utility bills or replacing medical equipment. Guidance issued under the tenure of Jeremy Hunt in October 2014 said that conditions could be set which could include: reductions in the use of temporary staff, "use of collaborative procurement routes" or "the adoption of

940-461: The FTs; any attempt by the statutory bodies to make a grab for them will be furiously resisted". By 2016, the distinction between foundation trusts and other NHS trusts was widely regarded as eroded, and in that year the two regulators were combined into a new body, NHS Improvement . The notion that every trust should become a foundation trust was abandoned, and the widespread financial crisis undermined

987-440: The Foundation Trust Network it was raised to 1.5%. These caps disappeared on 1 October 2012. Collective earnings from private patients increased 14%, from £346.1 million in 2012–13 to £395.9 million for 2014–15. Private earning is concentrated on specialist hospitals in London who see many patients from other countries. Most trusts have negligible private income. In order to achieve foundation trust status, NHS trusts have to pass

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1034-581: The NHS to reconsider "whether the model of foundation trusts is sensible", arguing "If one-third of the hospital system is permanently not demonstrating good viability and good governance, is that telling you something about actually how the system should run as opposed to how we thought it should run?". In January 2022 Sajid Javid , writing in The Times said he was planning a “revolution” that would allow “well-run hospitals more freedom”. Foundation trusts had

1081-693: The Royal Free Hampstead NHS Trust, comprising Royal Free Hospital and Royal National Throat, Nose, and Ear Hospital , became one of the first NHS trusts established under the provisions of the NHS and Community Care Act 1990. In August 2008, the trust announced its intention to form the UCLPartners academic health science centre with University College London , Great Ormond Street Hospital for Children NHS Trust , Moorfields Eye Hospital NHS Foundation Trust , and University College London Hospitals NHS Foundation Trust . UCLPartners

1128-399: The board of directors have no statutory duty towards the governors. The governors cannot, without the board of directors' permission, have any control over the direction of the trust, and cannot appoint or remove trust auditors. The chair and directors are not appointed by their board of governors. Barnet and Chase Farm NHS Hospitals Trust Barnet and Chase Farm Hospitals NHS Trust

1175-407: The board of directors to produce plans for the future development of the trust. It's also in charge of receiving, at a public meeting, copies of the trust's annual accounts, auditor's reports, and annual reports. The council of governors is composed of 25 members, of whom 6 are elected members from the public constituency, 5 are elected members from the staff constituency, and 7 are elected members from

1222-478: The chairman (currently Mark Lam) and Chief Executive (currently Peter Landstrom) of the trust. The role of the Board is to consider the key strategic and managerial issues facing the trust in carrying out its statutory and other functions. The Chief Executive is responsible for the overall performance of the executive functions of the trust. The trust also has a council of governors which is responsible for working with

1269-550: The council of governors to work towards a merger. A study undertaken in 2005 by the King's Fund of Homerton University Hospital NHS Foundation Trust found some governors disappointed and disillusioned. Another report in 2005, funded by the Nuffield Foundation , found that it was too easy to invite members to sit on sub-committees, where they quickly became bogged down in the minutiae of operational planning, whilst

1316-473: The hospitals led to a number of protests, including the formation of the " Save Chase Farm " party (2006-2010) which at one time had two members elected to the local council of the London Borough of Enfield . Final agreement to these changes, including the closure of the maternity and accident and emergency services at Chase Farm, came about in 2014. In May 2013, Barnet and Chase Farm Hospitals released

1363-534: The legislative basis was the Health and Social Care (Community Health and Standards) Act 2003 . The first ten NHS hospitals to become foundation trusts were announced in 2004. Gordon Brown prevented plans by Alan Milburn that they should be financially autonomous in 2002. By 2012, the Monitor website listed 145 foundation trusts. Successive governments set target dates by which all NHS trusts were supposed to have reached foundation status. For example, by 2009

1410-524: The main decisions were taken at meetings that they only heard about after they took place. The public's perception of foundation trust status implying a high standard of clinical care was changed by the Mid Staffordshire NHS Foundation Trust scandal of the late 2000s ( Stafford Hospital Scandal ) and the ensuing Francis inquiry , published in 2013. At the outset, some critics claimed that foundation trusts went against

1457-600: The patient constituency. When the trust took over Barnet and Chase Farm Hospitals Trust in 2014, it discovered a large backlog of patients waiting for elective treatment that year. By April 2015, the trust had reviewed 7,174 patients who have now received treatment. The review concluded that one patient "may have experienced serious harm" and 39 patients had "potentially" suffered "moderate harm", and 68 patients may have suffered "low harm". 1,541 patients were sent to private providers since July 2014, predominately for endoscopy and ear, nose, and throat treatments. In November 2014,

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1504-533: The private patient income cap but FTs have to do the majority of their work for the NHS. This restriction was kept to reassure those concerned about future developments that FTs would continue to have NHS work as their central concern. Previously each FT had its own cap, set at the level of its private activity when the first FTs were established in 2003/4. About three-quarters of all FTs had a cap of 1.5% or less. Until 2010 all mental health trusts were completely barred from undertaking non-NHS work, but after lobbying from

1551-412: The public sector and less autonomous than was originally expected. By March 2013 there were 145 foundation trusts, of which 41 were mental health trusts and three were ambulance trusts. They included acute trusts, mental health, community and ambulance trusts. By March 2019, the number of foundation trusts had shown a small increase to 151. The basic governance structure and form of foundation trusts

1598-406: The same month, University College London Hospitals NHS Foundation Trust took over management of Royal National Throat, Nose, and Ear Hospital from the trust. In 2013, the trust had an annual turnover of around £450m and employed around 4,600 staff. Royal Free Hospital has a total of roughly 900 beds and treats around 700,000 patients each year. In partnership with University College London (UCL) ,

1645-620: The spirit of the principles laid out by Aneurin Bevan , the founder of the NHS. Others feared that it would lead to a two-tier system. Others doubted whether foundation trust members would succeed in having any effective influence over hospital management. In 2011, some argued in a report financed by the Nuffield Foundation that the success associated with foundation trusts had been due to other factors than governance. In June 2014, Bill Moyes, former Monitor executive chair, urged

1692-476: The supposed autonomy when almost all had to rely on money borrowed from the Department of Health, to which strings were attached. Foundation trusts have some managerial and financial freedom when compared to NHS trusts . The introduction of foundation trusts represented a change in the history of the National Health Service and the way in which hospital services are managed and provided. At

1739-606: The time of introduction, they were described "as a sort of halfway house between the public and private sectors". This form of NHS trust is an important part of the United Kingdom government's programme to create a "patient-led" NHS with an internal market . The stated purpose is to devolve decision-making from a centralised NHS to local communities, in an effort to be more responsive to their needs and wishes. But after Gordon Brown prevented plans by Alan Milburn to make them financially autonomous they have been much more in

1786-420: The trust comprises University College London , Great Ormond Street Hospital for Children NHS Trust , Moorfields Eye Hospital NHS Foundation Trust , and University College London Hospitals NHS Foundation Trust . In 2016, it set up a project with DeepMind to develop new clinical mobile apps linked to electronic patient records . The first app will be used to detect acute kidney injury . Royal Free Hospital

1833-638: The trust has major research activities and it forms part of the UCLPartners academic health science centre . The Royal Free Hospital is also a teaching centre for the UCL Medical School . In March 2017, the trust sold land at Chase Farm Hospital in Enfield to the Royal Free Charity for £50m. The charity plans to use the land to provide housing for staff. The trust has a board of directors comprising eleven statutory members including

1880-545: The trust started a project to scan 750,000 documents using Kodak scanners as part of its move to paper free working. Business process outsourcing firm MISL was scanning partner in an operation which would take more than a year. The project aimed at analysing data of patients to identify previously unknown trends about medical conditions. The trust has access to patients' GP records in the Urgent Care Centre run by Haverstock Healthcare in its A&E department using

1927-529: The trust was selected by NHS England as one of twelve Global Digital Exemplars . In a report of the Care Quality Commission completed in May 2019, the trust's overall surgical safety rating was downgraded from “good” to “requires improvement”, due to a “large number” of “never events” — incidents so serious they should never have happened — which were partially related to “poor behaviours” by

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1974-769: Was a NHS hospital trust of the National Health Service in England, responsible for Barnet Hospital and Chase Farm Hospital , both of which are in North London . On 1 July 2014 Barnet and Chase Farm NHS Foundation Trust became part of the Royal Free London NHS Foundation Trust , which now comprises Barnet Hospital , Chase Farm Hospital and the Royal Free Hospital . The Trust was formed in 1999 at

2021-500: Was acquired by Royal Free London NHS Foundation Trust, making it one of the largest trusts in the country. The Free Hospital was founded in 1828 to provide free hospital care to the poor. A royal charter was granted by Queen Victoria in 1837 in recognition of the hospital's treatment of cholera victims. For a long period, the Royal Free Hospital was the only hospital in London to offer clinical instruction to women and

2068-571: Was built by the Spanish National Health System , but its operational management is contracted out to a private company, and exempt from many of the rules normally imposed on state-owned hospitals, and in particular, that hospital was allowed to negotiate its own contracts with workers. The governance of that hospital includes local government, trade unions, health workers and community groups. Foundation trusts were announced by Health Secretary Alan Milburn in 2002, and

2115-544: Was closely associated with the London School of Medicine for Women , later renamed Royal Free Hospital School of Medicine. Royal Free Hospital moved to its present site in the mid-1970s, bringing together the old Royal Free Hospital on Gray's Inn Road with the Lawn Road, New End and Hampstead General hospitals. The former Hampstead Children's Hospital became the nursing accommodation for the hospital. In April 1991,

2162-539: Was officially designated as an academic health science centres by the UK Department of Health in March 2009. In April 2011 the trust announced that it would be making 450 redundancies as part of a plan to reduce costs by £40m per year. The Royal Free Hampstead NHS Trust was authorised by Monitor as an NHS foundation trust on 1 April 2012, subsequently changing its name to Royal Free London NHS Foundation Trust. In

2209-611: Was revealed that more than 2000 patients waiting for surgery had not been registered on the waiting list, and that 242 had waited more than a year for treatment. It was said that this was a software problem. A review of 7,174 patients subject to delay by the Royal Free Trust in April 2015 found that one patient may have suffered “serious harm” and 39 “moderate harm”. 1,541 patients were sent to private providers between July 2014 and April 2015, predominately for endoscopy and ear, nose and throat treatments. The Trust predicted

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