A National Health Service trust is a division within the English NHS or NHS Wales generally serving either a geographical area (commonly the nominal service area of a hospital) or a specialised function (such as an ambulance service). In any particular location there will thus usually be two or more such bodies involved in the different aspects of health care for a resident.
The trusts are not trusts in the legal sense but are in effect public sector corporations. Each trust is headed by a board consisting of executive and non-executive directors, and is chaired by a non-executive director. Non-executive directors are recruited by open advertisement.
All trust boards are required to have an audit committee consisting only of non-executive directors, on which the chair may not sit. This committee is entrusted not only with supervision of financial audit, but of systems of corporate governance within the trust.
Types of NHS trust
There are several types of trust providing services for the NHS:
- NHS hospital trust (also known as an acute trust), which provides secondary care services
- NHS mental health trust
- NHS ambulance services trust
- Community Health NHS Trust
Foundation trust status may be applied for by the above categories of NHS trust. Successive governments have announced that all NHS Trusts should become NHS Foundation Trusts, and deadlines have been set for this transformation, which have repeatedly been missed.
Former types of trust
- NHS primary care trust (PCT) (abolished 1 April 2013), which provided primary care services, public health functions and commissioned secondary care services
- NHS care trust (abolished 1 April 2013), provided/commissioned health and social care services, usually with responsibilities of both a PCT and a local authority
Other types of NHS organisation
- NHS special health authority, organised on a national basis, dealing with NHS-wide issues
In addition there were in England (after reorganisation in 2006) ten strategic health authorities, organised on a regional basis, which had the responsibility of coordinating the strategies of the trusts in their regions. These were also headed by boards of executive and non-executive directors. They too were abolished in April 2013
- "NHS authorities and trusts". The NHS in England. NHS Choices. 28 January 2013. Retrieved 7 November 2013.
- "England and Wales: Strategic Health Authorities, Regional Offices, Primary Care Organisations and Local Health Boards, as at October 2006" (pdf). Office for National Statistics.