Top NHS trusts given new powers to improve care
Source: gov.uk (2025-11-12)

High-performing NHS trusts will be given more independence to deliver faster, better and more personalised care.

Thousands of NHS patients are set to benefit as the country’s best-run hospitals and community health trusts are set to be handed more independence - freeing local leaders from central bureaucracy so they can deliver faster, better and more personalised care.

Health and Social Care Secretary Wes Streeting today announced a major shift in how the NHS is run, ending decades of top-down control and giving the highest performing organisations new ‘advanced foundation trust’ status.

The new designation will reward the very best leaders in the NHS with even greater freedom to make decisions locally - from how services are organised to how money is spent - so that care can be designed around what works best for local people, not dictated from Whitehall.

If trusts have been careful with taxpayers’ money and have built up savings, they can speed up processes on improvements, including buying new scanners quicker or improving wards.

Health and Social Care Secretary Wes Streeting said:

Good leadership in the NHS has never mattered more.

Under our plans, if trusts manage their finances well, innovate and deliver for patients, we will give them the space to lead.

These reforms mark a fundamental shift from command and control to collaboration and confidence.

For the first time in years, the NHS can look forward with confidence rather than back in frustration.

Because we’ve got a plan that’s not just ambitious and realistic - we’ve got a plan that is working, and that is why the NHS is on the road to recovery.

This government has given all trusts more independence and freedom, but the new ‘advanced foundation trust’ designation will grant extra autonomy to local leaders who met a high bar of assessment.

Taken together, these reforms are designed to speed up the drive to cut waiting times, expand community-based care and reduce health inequalities as part of the 10 Year Health Plan (https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future).

Patients across the country will see care built around their needs, with more services delivered in the community, shorter waiting times, and new technology helping doctors, nurses and patients stay connected - from virtual wards and remote monitoring to shared digital records - so care is faster, more co-ordinated, and easier to access across hospitals, GPs and community teams.

NHS England has nominated 8 of the highest-performing trusts to become the first advanced foundation trusts, who will be among those eligible to be considered based on their record of delivering quality care, strong finances and effective partnerships with staff and local services.

These trusts will then be assessed by an independent panel.

Trusts that can prove they deliver good services and have sound finances will be able to spend any money they’ve saved since last year on new equipment, buildings and improving patient care. If the amount trusts want to invest is less than £100 million, the level of paperwork will be vastly reduced.

It’s designed to reward the best hospitals and cut through the red tape that has held back some improvements to patient care.

In return for greater autonomy and financial flexibility, the trusts will be expected to:
- deliver faster improvements in patient care, waiting times and productivity
- work closely with staff and commissioners
- help drive positive change across the wider NHS
Trusts granted this status will also need to demonstrate they are implementing the 3 big shifts of the 10 Year Health Plan - from sickness to prevention, hospital to community, and analogue to digital.

They will be independently reviewed at least every 5 years to maintain the highest standards and encourage continuous improvement.

Some trusts may also take on integrated healthcare organisation contracts, giving them control of the local health budget and responsibility for improving population health. This will support a shift in resources from hospitals to neighbourhood and community-based care.

The Health and Social Care Secretary also announced details of broader NHS modernisation (https://www.gov.uk/government/news/billions-to-be-redirected-back-into-patient-care-with-nhs-reform) which means patients will experience better care thanks to billions of pounds saved from ending duplication and slashing bureaucracy across the health service.

Nominated trusts

The trusts nominated for assessment are:
- Berkshire Healthcare NHS Foundation Trust
- Dorset Healthcare University NHS Foundation Trust
- Central London Community Healthcare NHS Trust
- Northamptonshire Healthcare NHS Foundation Trust
- Northumbria Healthcare NHS Foundation Trust
- Alder Hey Children’s NHS Foundation Trust
- Norfolk Community Health and Care NHS Trust
- Cambridgeshire Community Services NHS Trust