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Stronger safeguards are needed to protect partnership working between the NHS, primary care trusts and councils to prevent foundation hospitals failing groups such as those with mental health problems, an influential parliamentary committee has warned, writes Sally Gillen.

In its report on foundation hospitals, the first of which will begin operating next April, the health select committee says it is “strongly supportive” of the development of community-based care.

But it adds that it is “imperative” the trusts do not lead to a shift back in favour of acute services, and that people with chronic illnesses, such as those with mental health problems who are often treated in community-based care settings, are not marginalised.

They argue that, while three-star hospitals will be the first to gain foundation status, winning greater financial freedoms and less control from the department of health, poorer-performing hospitals may be starved of cash and become worse. A debate on the issue was due to take place in the House of Commons on Wednesday.

Committee chairperson David Hinchliffe said he had heard no evidence to reassure him that foundation trusts would not “entrench inequalities still further”, adding that the worst hospitals would become “locked into a spiral of decline”.

There are also concerns that those hospitals that win foundation status may not have increased power to develop locally driven targets, which could mean they are unable to direct greater resources towards, for example, children’s health improvement through Sure Start.

The report recommends that the government should clarify whether foundation trusts will have fewer national targets.   

Health secretary Alan Milburn envisages that every acute hospital will become a foundation trust within five years.

Mental health trusts are prevented from bidding for foundation status because their ratings system is relatively new and not well-developed, but the report urges the government to extend the status to mental health trusts as a “matter of priority”.

Primary care trusts are also excluded from applying because they are too young and, according to Milburn, need to “develop their ability to commission”.