all FTs had a cap of 1.5% or less. Until 2010 all mental health trusts were completely barred from undertaking non-NHS work, but after lobbying from the Foundation Trust Network it was raised to 1.5%. These caps disappeared on 1 October 2012. Collective earnings from private patients increased 14%, from £346.1 million in 2012–13 to £395.9 million for 2014–15. Private earning is concentrated on specialist hospitals in London who see many patients from other countries. Most trusts have negligible private income. Achieving foundation trust status In order to achieve foundation trust status, NHS trusts have to pass a variety of tests, which have changed over time. In 2003 only trusts with three stars from the Commission for Health Improvement were eligible for foundation status. In that year Aintree Hospitals, Essex Rivers Healthcare, Newcastle upon Tyne Hospitals and Walsall Hospitals were all downgraded to two stars and so did not make the first wave of foundation trusts. Highly secure psychiatric services (EFT) Formerly referred to as foundation trust equivalent (FTe) instead of Equivalent Foundation Trusts, this designation applies only to trusts providing high secure psychiatric services, of which there are three: Nottinghamshire Healthcare NHS Trust, West London Mental Health NHS Trust and Mersey Care NHS Trust. These trusts abide by the Department of Health definition of a foundation trust, but the Secretary of State for Health maintains a direct line of communication and accountability with them because he or she has the responsibility to provide healthcare to patients who have been detained under the Mental Health Act, and have been judged to pose a grave and immediate danger to the public. Unlike full foundation trusts, governors have no statutory role, and the board of directors have no statutory duty towards the governors. The governors cannot, without the board of directors' permission, have any control over the direction of the trust, and cannot appoint or remove trust auditors. The chair and directors are not appointed by their board of governors. See also History of the National Health Service List of NHS Trusts in England :Category:NHS Foundation Trusts Further reading References External links Foundation Trust Network Monitor Department of Health information on foundation trusts Public register of NHS Foundation Trusts Unison (January 2007 Revised edition). In the Interests of Patients? The impact of the creation of a commercial market in the provision of NHS Care. Accessed 2007-09-15 Allyson Pollock (2007-09-24) The Guardian: What