NHS Foundation Trusts, first introduced in April 2004, are different to other NHS trusts. They are independent legal organisations who have their own governance arrangements. They are accountable to local people, who can become members and governors. Each NHS Foundation Trust has a duty to consult and involve a board of governors (including patients, staff, members of the public, and partner organisations) in the strategic planning of the organisation. They are not regulated by central Government and are no longer performance managed by health authorities. As self-standing, self-governing organisations, NHS Foundation Trusts are in control of their own future. Foundation Trusts have financial freedom and they can retain monies not spent to invest in improving their Hospital and services. Foundation Trusts are overseen by Monitor who are a non-departmental public body established in 2004. They are the sector regulator of NHS-funded health care services. Their main duty is to protect and promote the interests of patients.

Non-Executive Directors are members of the board of directors who do not form part of the executive management team, they are not employees of the organisation. Their role is to;

• Challenge and contribute to the strategy of the Trust
• Scrutinise the performance management of the Trust (including A&E targets, 18 Week RTT standards and Cancer targets
• Satisfy themselves that financial information is accurate
• Appoint the Executive Directors

• Resources
• Appointments
• Standards of conduct

The Executive Directors of a Hospital are usually;

• Chief Executive
• Head of Finance
• Head of Human Resources
• Clinical Director
• Head of Nursing
• Head of Planning and Performance
• Head of Operations (not surgical operations)

Primary care is the health care administered by a health care provider. This provider is the first point of contact for patients and they can then arrange other specialists that the patient may need during the pathway of their care. The main provider is a General Practitioner (GP) who can then refer the patient on to secondary care. Secondary care is defined as a service provided by medical specialties who generally do not have first contact with patients. Secondary care is usually delivered in Hospitals or clinics and patients have usually been referred to secondary care by their primary care provider, usually their GP. Secondary care also includes Accident and Emergency, Maternity, Intensive Care and Imaging.

There are two types of visits to a Hospital for a patient; Outpatients - Some patients go to Hospital just to receive a diagnosis, treatment or therapy and they are classed as 'Outpatients' as they do not stay overnight. Inpatients - Some patients are admitted to Hospital for day case surgery or longer, these patients are 'Inpatients'.