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Governance in NHS Foundation Trusts: Insights from Company Secretaries
Abstract
NHS Foundation Trusts (FTs) came into existence in 2004 as part of a suite of system reforms that reintroduced a healthcare market in England. Over the last decade over half of the 265 English NHS Trusts have made the transition to FT status and to a new form of corporate governance that is accountable to locally elected governors. Whilst research into the governance arrangements for these new entities has explored several theoretical frameworks, no model has satisfactorily explained the rationale for the adoption of a commercial governance code underpinned by a democratic accountability process. In this chapter, the authors draw on insights of FT company secretaries, through a series of semi-structured interviews and questionnaires, to explore alternative governance models and to make recommendations that might improve the functioning of elected governors within FTs.
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