Policy paper

Health and Care Bill: new trusts

Updated 10 March 2022

This was published under the 2019 to 2022 Johnson Conservative government

This fact sheet explains how the government plans to give the Secretary of State the power to create new trusts to ensure the health system is structured to deliver the best outcomes for whole population health and respond to emerging priorities.

Background

We want to ensure that the health system is structured to deliver the best outcomes for the whole population. NHS trusts, which provide healthcare services including your local hospital, often want to merge together to better organise themselves to deliver care. One option that local systems might want to consider is to create new NHS trusts, for example to help integrate care. We want this to be an option for local systems where they think it is in the interests of their local population.

When the Health and Social Care Act 2012 was passed, it was expected that all NHS trusts would develop foundation trust status and once there were no NHS trusts left, NHS trusts could be abolished along with the ability to create new NHS trusts. However, NHS trusts remain an important part of the provider landscape in the NHS, making up around a third of providers. The Bill provides for the repeal of the provisions for the abolition of NHS trusts and the continuation of the legislative provisions governing such trusts, including the power to establish new trusts.

What the bill will do

We need a health system that can adapt to meet current and future challenges. This includes having the option to create new trusts where it is in the interest of the whole population. This legislation will make clear that the Secretary of State has the power to create new NHS trusts and will continue to do so in the future.

In practice we would expect Integrated Care Boards, on behalf of the whole system, to apply to the Secretary of State to ask him to set up a new NHS trust. This will ensure that there is local support to establishing a new trust.

The Bill will also allow for NHS bodies (NHS trusts and NHS foundation trusts) to apply to NHS England to transfer liabilities, rights and property to another NHS body. NHS England will review these applications to ensure all reasonable steps have been taken to prepare for that transfer. This will be done with the view to ensuring the transfers are in the best interests of patients and the wider health and care system.

How these provisions help to reduce bureaucracy

The ability to create new trusts will reduce the likelihood of bureaucratic and cumbersome workarounds as the system will have the flexibility to arrange itself in the best way for patients.