THERE are advantages to being special, and foundation trusts are making the most of their station.

Nursing Times (May 29) reports that these trusts are using their independent status to opt out of reporting clinical incidents, saying the guidance on reporting incidents to the National Patient Safety Agency (NPSA) does not apply to them.

Ben Thomas, the NPSA’s safer practice lead for mental health, says: “Foundation trusts are now saying that they don’t feel there’s a necessity for them to report. If there’s been a homicide they don’t feel [that] the guidance, as it currently stands, applies to them.”

It is not mandatory for any trust to use the reporting system, but a large majority of NHS trusts are signed up to it. Gail Adams, Unison’s head of nursing, says: “The one way we can ensure patient and service user safety is to require all organisations to monitor and report information in a clear and consistent way – irrespective of where that provider is.” But Monitor, the foundation trust regulator, says it is up to individual foundations trusts to decide.

Those who want that special footing will have to work harder for it in future. Health Service Journal (May 31) says that applying for foundation trust status will become tougher as Monitor responds to an expected rise in acquisitions and mergers in 2007-08.

Monitor is anticipating the changes because it says the NHS will want to reorganise provision in order to tackle long-standing financial weaknesses. Acquisitions require Monitor to risk-rate the postacquisition organisation, and mergers need a full, new authorisation. It is expected that this will have a knock-on effect on Monitor’s capacity to carry out authorisations.

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