The 10 Year Health Plan aims to give power back to frontline NHS leaders through a reinvigorated and reinvented rules-based foundation trust model that will re-empower provider boards to make decisions locally and improve services for patients and communities.

Advanced foundation trust status is a marker of excellence for providers who 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 are eligible for advanced foundation trust status. Those who pass our assessment will benefit from greater strategic and operational autonomy, recognising their high capability and empowering their leaders to drive accelerated change and improvement on behalf of their patients and staff.

The policy framework underpinning the Advanced Foundation Trust Programme and details of the eligibility criteria and assessment approach, set out in the guide for applicants, have been published alongside a response to the consultation launched in November 2025.

Organisations achieving advanced foundation trust status 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 (CQC) ratings and the quality domains within the NHS Oversight Framework.

Information about the NHS trusts and foundation trusts who currently hold advanced foundation trust status can be found in the advanced foundation trust directory.

Advanced foundation trusts 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 requires an additional assessment of capability and readiness.

Two organisations, Northamptonshire Healthcare NHS Foundation Trust and Northumbria Healthcare NHS Foundation Trust, are currently undergoing 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.

Organisations being assessed for advanced foundation trust status 

Our ambition is that all NHS trusts and foundation trusts will be approved as advanced foundation trusts by 2035. The second wave of the Advanced Foundation Trust Programme is planned to include 16 trusts who will begin assessment in 2026/27:

• Guy’s and St Thomas’ NHS Foundation Trust
• Imperial College Healthcare NHS Trust
• Kent Community Health NHS Foundation Trust
• Liverpool Heart and Chest Hospital NHS Foundation Trust
• Midlands Partnership NHS Foundation Trust
• North West Ambulance Service NHS Trust
• Royal National Orthopaedic Hospital NHS Trust
• Royal Papworth Hospital NHS Foundation Trust
• The Christie NHS Foundation Trust
• The Clatterbridge Cancer Centre NHS Foundation Trust
• The Royal Marsden NHS Foundation Trust
• The Royal Orthopaedic Hospital NHS Foundation Trust
• The Walton Centre NHS Foundation Trust
• University College London Hospitals NHS Foundation Trust
• West London NHS Trust
• Yorkshire Ambulance Service NHS Trust 

As well as meeting the eligibility criteria set out in the guide for applicants, organisations in this second wave have also demonstrated consistent high performance by being placed in segment 1 of the NHS Oversight Framework for all 4 quarters of 2025/26.

Recognising the strong organisational capability of these trusts, assessments for the second wave of the programme are intended to be streamlined.