News / Regulator passes value assessment

02 March 2014

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Regulator Monitor has achieved value for money in regulating foundation trusts and has been effective in helping trusts in difficulty, according to the National Audit Office.

The audit body said the regulator’s standards and processes for assessing NHS trusts applying for foundation status were ‘rigorous’ and had been adapted and strengthened. Just three of the now 147 FTs had breached their regulatory conditions within 12 months of being authorised.

In addition, of the 122 FTs authorised since April 2005, just 10 trusts had been classified as high financial risk and six as high governance risks within 12 months of being authorised.

The NAO said that for some trusts that ran into problems after authorisation, some of the underlying issues were likely to have been present at authorisation.

Monitor’s interventions were judged to have helped trusts in difficulty to improve. Although the specific impact was hard to identify, trusts said the regulator’s involvement had led to faster or more effective action. Action had been particularly effective where the underlying issues were internal to the trust, such as poor leadership or financial management. Some FTs had changed their chair or chief executive in response.

But Monitor’s influence was judged to have been less effective where the problems related to issues in the local health economy.

The report said the growth in risk in the FT sector may put ‘unsustainable pressure’ on Monitor’s capacity to regulate trusts in difficulty or maintain continuity of services.

‘Bigger challenges lie ahead for Monitor as it takes on its significant new responsibilities that stretch across the whole health sector,’ said NAO head Amyas Morse (pictured). ‘In addition, as Monitor itself recognises, it needs to adapt how it works with other bodies to tackle underlying local weaknesses that increase the risk of individual trusts failing, either clinically or financially.’