4.14 NHS foundation trusts were established in 2004. It was expected that all NHS trusts would eventually apply for foundation trust status and therefore benefit from the incentives of a greater level of financial autonomy, including the ability to retain surpluses. At 31 March 2019, there were 227 NHS providers, of which 77 (34%) retained non-foundation trust status. These 77 non-foundation trusts will continue to have their capital limits determined centrally. For the 150 NHS foundation trusts (66% of NHS providers), NHSE&I has proposed that NHS Improvement should have the power to set annual capital spending limits for these providers, with each use of the power applying to a single named foundation trust individually and which automatically ceases at the end of the financial year, with the reasons for the use of the power published. This is intended to improve the Department's ability to plan its capital spending within its spending limit. If implemented, this may limit the ability of foundation trusts to draw on any surplus they have earmarked for capital investment. This greater autonomy was also seen as an incentive for achieving fiscal balance.