What is the role of the Governors of an NHS foundation trust?

These are still early days for foundation trusts – or “public benefit corporations” as the Health and Social Care (Community Health and Standards) Act 2003 calls them.

Curiously, this Act created a completely new corporate structure in the context of health legislation. Although now approaching three years old, these novel corporate entities are mere striplings beside their more elderly colleagues, companies and mutual societies, which have been around for 150 years or more and are still evolving.

Foundation trusts are not only new, but their governance arrangements are novel, being based upon two groups of officers (directors and governors) rather than just one (directors alone) which is more common. Co-operative and other mutual societies, on which foundation trusts are modelled, have two groups (elected representatives and appointed professional managers), but the allocation of functions in those organisations is not the same as foundation trusts. It is therefore not surprising that the role of the governor of a foundation trust should be the cause of some puzzlement.

It is healthy to be open and honest about the novelty of these arrangements – there is no direct parallel – and to have an open discussion about how best to make them work. The comments below are intended to assist in that debate, and are based upon working with a number of applicant and authorised foundation trusts, and also with other large mutual or membership-based organisations.

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