Some hospitals in England are managed by acute trusts, some of which have also gained foundation trust status. Acute trusts ensure that hospitals provide high-quality healthcare and check they spend their money efficiently. They also decide how a hospital will develop to improve services. Acute trusts can also provide services in the community.
Most hospitals in England are now managed by NHS foundation trusts. Foundation Trusts are independent legal entities and have unique governance arrangements. They have financial freedoms and can raise capital from both the public and private sectors within borrowing limit.