Currently NHS Improvement is of the view that non-foundation trusts do not have the power to enter into such “corporate vehicles”. This can limit their options when looking at ways to share back office services or setting up innovative ways of delivering services. Many STP areas contain both NHS trusts and FTs, so they could have to use other ways of joint working.

Bevan Brittan has called for this stance to be reconsidered to allow greater freedoms for NHS trusts. Health secretary Jeremy Hunt could use a statutory instrument to give NHS trusts the necessary powers without needing new legislation.

Bevan Brittain partner David Owens said: “The current situation creates a problem with some of the things we are expecting to see coming out of the STPs around implementing Carter through shared services.”

Two organisations often want to form a joint venture to deliver a shared service so they can be equal partners but this is harder to do if one is an NHS trust, he said.

He added this could also be an issue if GPs wanted to join with a community NHS trust as a multispecialty community provider – one partner would have to take the lead and potentially subcontract to others. The law firm has been approached by trusts wanting to enter joint ventures around pharmacy and estates, but were restricted in how they could do so. There could also be questions over how ACOs could be established.

A spokesperson for the Department of Health said: “While there is currently no specific power for NHS trusts to create or participate in a joint venture company (except for income generation) the Department is committed to developing new models of care as part of the Five Year Forward View. As such, we would always work with NHS organisations and national bodies to consider any requests that would deliver more advanced and efficient care across the health system.”

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