The 10 Year Health Plan aims to give power back to frontline NHS leaders through a reinvigorated rules-based foundation trust model that will re-empower provider boards.

Advanced foundation trusts will be the new marker of excellence for providers that drive the delivery of the three shifts, bring down waiting lists and work with partners to improve population health.

Both NHS trusts and foundation trusts will be able to apply for advanced foundation trust status, with those that pass our assessment given greater autonomy and financial freedoms.

Reinvigorating the foundation trust model will incentivise good performance, giving well-governed and capable boards more freedom to respond to the needs of their communities and deliver improved care.

On 12 November 2025, the Secretary of State for Health and Social Care announced that 8 trusts will be among those assessed as part of the first wave of the Advanced Foundation Trust Programme next year:

1. Berkshire Healthcare NHS Foundation Trust
2. Dorset Healthcare University NHS Foundation Trust
3. Central London Community Healthcare NHS Trust
4. Northamptonshire Healthcare NHS Foundation Trust
5. Northumbria Healthcare NHS Foundation Trust
6. Alder Hey Children’s NHS Foundation Trust
7. Norfolk Community Health and Care NHS Trust*
8. Cambridgeshire Community Services NHS Trust*

* These two trusts are proposing to merge on 1 April 2026

These organisations have shown they are delivering the public’s priorities and value for money, as measured by the NHS oversight framework, and that they are providing high quality care to patients as measured by Care Quality Commission ratings.

This first wave of applications will be assessed against the three priority areas of leadership, quality and financial sustainability. As this is a reinvention of the foundation trust model for modern times, our process will include looking at how well a trust works with others and their plans to help deliver the three shifts set out in the 10 Year Health Plan.

Advanced foundation trusts will also have the opportunity to be designated as eligible to hold an integrated health organisation (IHO) contract to oversee the health budget for a defined local population. This will require an additional assessment of capability and readiness.

Two organisations in the first wave of applicants will also undergo additional assessment for designation to be eligible to hold an IHO contract. Organisations designated as IHOs in 2026 will work with NHS England and their commissioners to co-develop the model during 2026/27. We anticipate the first IHO models will go live in 2027.

NHS England is currently consulting on the guide for applicants as part of the Advanced Foundation Trust Programme which outlines how NHS trusts and foundations trusts will be assessed for advanced foundation trust status, as well as details on the additional IHO designation assessment criteria.