UT/2023/000021 - [2024] UKUT 00334 (TCC)

The 2006 Act refers to a number of different types of health body, such as National Health England, Clinical Commissioning Groups, NHS trusts, and NHS foundation trusts. As regards NHS foundation trusts, s43 provides:

“43 Provision of goods and services

(1)

The principal purpose of an NHS foundation trust is the provision of goods and services for the purposes of the health service in England.

(2)

An NHS foundation trust may provide goods and services for any purposes related to—

(a)

the provision of services provided to individuals for or in connection with the prevention, diagnosis or treatment of illness, and

(b)

the promotion and protection of public health.

(2A) An NHS foundation trust does not fulfil its principal purpose unless, in each financial year, its total income from the provision of goods and services for the purposes of the health service in England is greater than its total income from the provision of goods and services for any other purposes.

(3)

An NHS foundation trust may also carry on activities other than those mentioned in ... for the purpose of making additional income available in order better to carry on its principal purpose.”

As explained in Mr Sands’ evidence, the Trust was formed following a merger between South Staffordshire and Shropshire Healthcare NHS Foundation Trust and Staffordshire and Stoke on Trent Partnership NHS Trust on 1 June 2018. It provides physical and mental health, learning disability and adult social care services across Staffordshire, Stoke-on-Trent and Shropshire as well as a “vast range of community services for adults and children and specialised services such as rheumatology and rehabilitation which are delivered in venues ranging from health centres, GP practices, community hospitals and people’s own homes.”

Mr Sands also explained that the Trust is a “public benefit organisation” and that, as a “non-profit making NHS organisation, any surpluses are re-invested in improving services. In relation to any deficit for the services these would be subsidised from the Trusts overall budget.”

The 2006 Act also concerns other NHS entities such as Clinical Commissioning Groups. Mr Sands explains how the Trust previously provided health visiting and sexual health services free to the public before 2012, with funding coming through Public Health England (Footnote: ²) and Clinical Commissioning Groups. The Trust itself employs staff from both the health and social care professions.(Health visitors for instance are specialist public health nurses who are either registered nurses or midwives who have undertaken a year’s further post registration training in child health, health promotion, public health and education). The Trust also has leadership, management and HR staff to support these functions.

Following the 2012 changes and the imposition of statutory duties on the local authorities, the related funding now comes from the local authority concerned rather than from a Clinical Commissioning Group.

Mr Sands goes on to explain how, over time, local authorities decided to put these services out to tender. He describes how the Trust won local tenders and also some for out of county sexual health and health visiting (providing “children 0-19” services for Staffordshire County Council and Stoke on Trent City Council and sexual health services for Staffordshire County, Stoke on Trent, Shropshire, Telford and Wrekin, Leicester City and Leicestershire and Rutland County Councils).