NHS Improvement

NHS Improvement came into operation on 1 April 2016, resulting from the de facto merger of Monitor and the NHS Trust Development Authority (TDA). The government had announced in June 2015 that the two regulators would work more closely together under a single leadership team. The move meant that one organisation was responsible for overseeing all NHS providers. It aimed to simplify the regulatory landscape, by giving trusts (both foundation and NHS) the same access to support or interventions.

Monitor and the NHS TDA

Monitor had been established in 2004 as the independent regulator of foundation trusts. The Health and Social Care (Community Health and Standards) Act 2003 gave increased managerial and financial autonomy to NHS trusts authorised as Foundation Trusts. Monitor subsequently became the sector regulator for health services in England, following the Health and Social Care Act 2012.

The NHS TDA was a special health authority established by the National Health Service Trust Development Authority (establishment and constitution) order 2012 to oversee, develop and support NHS trusts in England on behalf of the Secretary of State. The NHS TDA was originally intended to be a time-limited body that would be wound down when all NHS trusts had achieved foundation trust status.

Later developments

NHS Improvement underwent a further de facto merger with NHS England in 2019. However, NHS England, Monitor and the NHS TDA remained separate bodies in the eyes of the law.


Monitor and NHS Trust Development Authority.
Monitor is now part of NHS Improvement [webpage].
UK government; 2016.

Department of Health.
Government announces Monitor and Trust Development Authority move to single leadership to deliver increased support to hospitals [webpage].
UK government; 2015.

Public Health England.
HPV vaccination for men who have sex with men: year 1 pilot.
Public Health England; 2018.

NHS England and NHS Improvement.
NHS England and NHS improvement: Working together [webpage].
NHS; 2019.