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Monitor sets out new approach to key aspects of how it regulates the health sector


Monitor is updating the regulatory framework under which it will ensure NHS foundation trusts are well run and can continue to deliver good quality services for patients in the future.

This takes into account changes following the Health and Social Care Act 2012 and will apply to all foundation trusts from October 1.

As the sector regulator, they will use the new framework to monitor foundation trusts, assessing both how well they are governed and any potential risk to their financial sustainability.

Where the framework indicates a concern, Monitor will consider whether to request additional information or launch a formal investigation into the situation at a trust and, subsequently whether to take regulatory action.

Judgements on when to intervene on behalf of patients will be made in a proportionate and transparent way, based on available and relevant evidence while not adding unnecessarily to the burden on trusts.

Under the Risk Assessment Framework, a governance rating will highlight any concerns we have with the way a trust is being run, and what regulatory action we are taking. A continuity of services risk rating will represent Monitor's view of the level of financial risk a provider is running and what Monitor is doing about it.

In addition, where local commissioners decide which essential services need to be protected if a provider gets into financial difficulty, Monitor will work with the trust to take steps to ensure these services are safeguarded.

The revised regulatory regime also recommends that foundation trusts should commission an independent review of their governance every three years.

The framework will be further updated in due course to cover those independent sector providers licensed to deliver key NHS-funded services required by local commissioners from April 2014.

Adrian Masters, Monitor’s Managing Director of Sector Development said:

"A trust that is well run and financially secure can provide the good quality services that patients expect. We’ve designed this new regulatory system to provide us with early warnings about where we need to take action to safeguard vital services on behalf of patients."

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