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  • 14 August 2023
  • 9 min read

How Many NHS Trusts Are There In The UK?

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    • Laura Bosworth
    • Richard Gill
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  • 10625
NHS Trusts in the UK“As of 2022, there are 215 NHS trusts across the UK. However, this is a number that is subject to change.”

This article is a helpful resource for anyone wanting to know more about how many NHS Trusts exist in the UK.

NHS Trusts are different units within the NHS, all across England and Wales, divided either by geographical area or function.

In some locations, there can be several trusts serving all kinds of different healthcare specialisms (for example, mental health trusts or community health trusts).

So while trusts are all part of and committed to the NHS, they each have their own focus and freedom to meet the demands within their different locations or specialisms. Because they are split both geographically and sometimes by function, there are many NHS trusts across the UK.

And a question we are often asked is how many NHS trusts there are in total.

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How Many NHS Trusts In UK?

As of 2022, there are 215 NHS trusts across the UK.

However, this is a number that is subject to change. That’s because new trusts are often created, or existing trusts sometimes merge. For example, the University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) was, before 2020, two separate trusts.

In fact, when the trust system was first established back in 1991, there were only 57.

How Many Hospitals Do NHS Trusts Manage?

The number of hospitals managed by NHS trusts varies across the UK.

Some trusts, like Manchester University NHS Foundation Trust, manage as many as 10, while others are far smaller.

So really, there is no correlation between trusts and the number of hospitals or healthcare settings they manage.

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How Many Doctors, Nurses And Managers Are There Across NHS Trusts?

Currently, there are approximately 132,900 Doctors, 350,600 Nursing staff and 36,600 managers within the NHS.

Although nursing and doctor numbers have grown overall in the last 10 years, the numbers aren’t growing nearly quickly enough. There are well in excess of 100,000 vacancies within the NHS, and that number continues to grow.

This number fluctuates considerably, the overall trend doesn’t. Put simply, the NHS continues to make supply meet demand, with more people leaving the workforce than joining it.

What Has Been The Long-Term Trend For Hospital Numbers Across NHS Trusts?

In terms of the long-term trends around hospital numbers within each NHS Trust, the picture is quite complex. Because of the way hospitals are managed and organised, it’s very difficult to ascertain an accurate number.

But we do know that there is a hunger for growth. The long-term trend, at a very broad level, is a growing number of hospitals, and therefore a growing number of hospitals for NHS trusts to manage.

The government recently committed to building 40 more by 2030.

However, most analysts say that the number of hospital beds is a more useful and insightful measure.

This number, at the most recent count, stands at 141,960. That number has, remarkably, halved in the last 30 years.

Meanwhile, demand has increased dramatically over the last 30 years – all of which goes a long way to explaining some of the challenges faced by the NHS today.

As of 2022, there are 215 NHS trusts across the UK.

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Is The Planned Growth In Hospital Numbers Likely?

The target of 40 new hospitals by 2030 was a key pledge of Boris Johnson’s election campaign in 2019.

However, a recent audit by the National Audit Office found that only 32 are likely to be finished, and that many will be too small to meet the needs of their communities.

The plans have also been complicated by changing definitions of the plan itself.

After Rishi Sunak became prime minister, the definition of ‘new hospitals’ was altered to include a new building or wing within an existing hospital or a major refurbishment.

The policy has inevitably been criticised as a result, with many analysts suggesting that no clear budget was set when the pledge was first made.

What Impact Did Covid-19 Have On NHS Hospital And Trust Numbers?

Although hospitals and NHS trusts had to dramatically change much of their operations to cope with the demands of the pandemic, there was no significant shift in hospital or trusyt numbers during the pandemic.

The biggest and best-known changes related to the so-called Nightingale hospitals.

The Nightingale hospitals were seven temporary hospitals built during the first wave of Covid-19. That included a particularly large site at London’s ExCel centre.

This site ended up only treating 54 patients during the first wave, despite a 4000-bed capacity.

Subsequently, these hospitals closed permanently in April 2021, despite a few being converted to testing centres.

What Is The Biggest NHS Trust?

The biggest NHS Trust is Manchester University NHS Foundation Trust, as mentioned above.

It operates 10 hospitals and has nearly 30,000 staff.

The picture from the CQC and the media has been similar ever since: staffing shortages have led to a lowering in standards from NHS trusts, and patient safety is at risk.

What Is An NHS Foundation Trust?

Some trusts are also described as ‘foundation’ trusts. And although they are very similar to any other trust, there is a small distinction.

Foundation trusts are more focused on empowering local communities and devolving central government decision making.

Therefore, at least in theory, a foundation trust should have more autonomy in shaping their services to suit the needs of local residents.

What Does The Future Hold For NHS Trusts?

The NHS as a whole is now fully committed to the Trust system – that is, a system in which the 215 NHS Trusts manage hospitals and healthcare services within a given region.

Inevitably, some trusts are performing better than others. The Care Quality Commission (CQC) is a body that rates each trust and offers one of these four ratings: outstanding, good, requires improvement or inadequate.

These criteria are applied across different assessment areas, including safety.

Notably, in recent years, many trusts have been found by the CQC to be failing to meet safety standards. Nearly 100 trusts in 2019 were rated as ‘requires improvement’ on safety standards, and six were rates as ‘inadequate’.

The picture from the CQC and the media has been similar ever since: staffing shortages have led to a lowering in standards from NHS trusts, and patient safety is at risk.

The most obvious answer to this problem is increased funding for the NHS, which is starting to come. Funding over the next five years will increase by an average of 3.4% a year, compared with 2% a year across the previous five years.

This is positive, but most critics argue it isn’t enough – and that the problems faced by trusts can’t be solved by investment alone.

For starters, recruitment and retention has to improve – and they’re issues that won’t be solved purely through funding.

So, while there is hope for improvement, the short-term outlook for NHS trusts continues to be challenging.

Other Relevant NHS Trust Statistics

• In May 2023, the number of people on the waiting list for hospital treatment within the NHS rose to a record of 7.5 million

• In December 2022, the proportion of people spending over 4 hours waiting in A&E rose to over 50% for the first time. It has dropped since

• There are 22% more Doctors and 18% more Nurses working in the NHS than there were five years ago

• In May 2023, there were approximately 27.7 million GP appointments. This is 15% more than in May 2019

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About the author

I believe people working in healthcare should be able to choose to enjoy work. That is, choose an employer who reflects their values and provides them with a sustainable career. This leads to better patient care, higher retention rates and happier working lives in this most important employment sector.

    • Laura Bosworth
    • Richard Gill
  • 0
  • 10625

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