Recommendation 70

Duty of utmost good faith

A duty of utmost good faith should be imposed on applicants for Foundation Trust status to disclose to the regulator any significant information material to the application and to ensure that any information is complete and accurate. This duty should continue throughout the application process, and thereafter in relation to the monitoring of compliance.

NHS Trusts are expected to be open with the NHS Trust Development Authority and regulators throughout the foundation trust application process. In order to further support this duty of utmost good faith, the NHS Trust Development Authority will explicitly ask trusts if they have anything to declare in relation to their application in the final board-to-board meeting before it is formally considered by the board of the NHS Trust Development Authority for approval to proceed to Monitor.

The Care Quality Commission is working closely with both Monitor and the NHS Trust Development Authority to ensure that all applicants are subject to inspection so that comprehensive, up-to-date information on the quality of care and governance process is available at the appropriate stages of the application process, and prior to any decision by the board of the NHS Trust Development Authority as to whether a foundation trust application will be supported. Monitor also now requires all applicants to sign a letter to confirm that they have provided all information relevant and material to the foundation trust assessment process.

The Care Quality Commission is also involving Monitor and NHS Trust Development Authority in developing its new inspection methods and surveillance model, so as to ensure that opportunities for information-sharing are identified and used fully on an on-going basis.

In addition, as set out in recommendation 173, every healthcare organisation and everyone working for them must be honest, open and truthful. This will build upon the existing requirement of Monitor’s licence that information provided is accurate, complete and not misleading and the expectation that licence-holders notify Monitor in the event of any incident, event or report that may raise concerns over compliance with their licence.

No further update is required. Please see response to the recommendation in Hard Truths