World class expertise, local care

Since our foundation in 1828, the Royal Free London has had a pioneering history, leading the way in many areas of healthcare: advancing our understanding of illness; taking advantage of the latest technology; developing new and better therapies; and tackling health and social inequalities.

That pioneering spirit continues to be central to our approach today, and contributes to our record of delivering some of the best clinical outcomes for patients across our local and specialist services. 

As a large NHS foundation trust, we employ more than 12,000 staff from 120 countries, serve a population of more than 1.6 million people across 70 sites in north London and Hertfordshire and are one of the biggest providers of cancer care in the UK.

We want to bring the best of the NHS to every patient, no matter which of our hospitals or services they visit.

We aim to achieve this through our three-fold mission of delivering world class treatment and local care, underpinned by groundbreaking research and the very best in class for learning and education.

From our three main hospitals and at various other satellite sites and hospital trusts, we offer local services for local people.

hospital_1.pngOur three main hospitals:

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7,500+ babies delivered in 2022-2023


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40,000 planned operations per year


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17 million tests per year performed in our labs


We attract patients from across the country and beyond to our specialist services in liver, kidney transplantation, haemophilia, renal, HIV, infectious diseases, plastic surgery, immunology, vascular surgery, Parkinson’s disease, cardiology, amyloidosis and scleroderma. 

The Royal Free Hospital has a world-leading high-level isolation unit for the care of patients with the Ebola virus and similar infectious diseases. We were one of the first four trusts to treat UK patients for COVID-19 at this centre in February 2020.

We are also immensely proud of our leading role in research, undertaking more than 200 research projects a year involving more than 13,000 patients, and our strong tradition in educating, developing and training both the future NHS workforce and our current staff.

Our mission

Our mission is to be world class in terms of our healthcare services, clinical research and teaching excellence. 

This tripartite mission underpins everything we do, from the care we deliver to our patients to the way we develop and give opportunities to our staff.

Our clinical strategy

Our five-year clinical strategy is an ambitious plan that will transform how we deliver world class care and the way people access our services.

Published in June 2024, it sets out our clinical vision for how we deliver world-leading healthcare for all our patients, meet growing demands on our services and create a healthier future for our local communities.

Local clinical priorities

Each of our hospitals has new clinical priorities which reflect the needs of the patients we care for. These are:

Barnet Hospital

Supporting the needs of an ageing population and transforming same day and integrated care.

Chase Farm Hospital and group clinical services

Developing different types of surgery and focusing on early diagnosis and prevention through our group clinical services.

Royal Free Hospital

Establishing a national centre of academic and clinical excellence for rare diseases, and working with our partners to reduce chronic diseases and improve patient outcomes.

Group clinical priorities

We’ve also identified three group-wide clinical priorities:

  • cancer
  • cardiovascular
  • organ failure and transplantation

We play a leading role in these areas within north central London and beyond, and they have a significant impact on the health of our local populations.

Our world class care values

All of our staff are expected to treat our patients, visitors, and each other, in line with our world class care values which expect us to be positively welcoming, actively respectful, clearly communicating and visibly reassuring.

Trust values as icons and text

Our trust values were chosen by our patients and staff and underpin all we do.

Our objectives

Our governing objectives inform the direction and decision-making of the Royal Free London group, setting out how we will achieve our mission. They are:

RFL excellent health outcomes stamp.pngExcellent health outcomes 

Consistently deliver excellent and equitable care that provides access to research for all our patients.​​​​​

RFL outstanding experience of care stamp.pngOutstanding experience of care

Ensuring the experience of our patients and carers is among the best in the country.

RFL outstanding experience for our people stamp.pngOutstanding experience for our people

Where colleagues feel a strong connection to their work and organisation and are enabled to deliver and to realise their potential.

RFL be a sustainable organisation stamp.pngBe a sustainable organisation

Financial: contribute to the elimination of the north central London system deficit on a recurrent basis.
Environmental: reduce carbon emissions towards net zero by 2040.

Read more about how we are achieving these objectives in our annual report

Alongside our governing objectives, our clinical strategy outlines our group-wide clinical priorities, focusing on cancer, cardiovascular, and organ failure and transplantation with individual priorities for each of our hospital sites and partnerships to be developed in 2023-2024. 

Our research and education strategies are also linked to our objectives, helping us achieve our tripartite mission of globally recognised clinical expertise with local and friendly hospital care. 

As part of our group model, we not only oversee our three hospitals and satellite sites, but we lead and share services and resources with a group of NHS providers in north central London. 

This allows us to work collaboratively, forging partnerships to deliver the best care possible and operate at scale to get the best investment and quality services. 

Our current clinical partners are North Middlesex University Hospital NHS Trust, West Hertfordshire Hospitals NHS Trust and Royal National Orthopaedic Hospital.  

We are also working more closely with our non-hospital partners in the NHS and social care to help people to live longer in good health, rather than just treating people when they are sick. Our group helps us to deliver this aspiration.

The Royal Free London as a foundation trust

Foundation trusts are NHS organisations which are free from central government control but who are accountable to the communities they serve and the commissioners who contract their services. 

They continue to strive to exceed the standards that NHS trusts must achieve, including complying with the requirements of the Care Quality Commission — the independent regulator of healthcare services in England. 

As a foundation trust, the Royal Free London is led by a board of directors and, with our governors and members, we have greater freedom to decide our own strategy and the way services are run. 

The NHS constitution

We are fully committed to the NHS Constitution and its requirements for the delivery of NHS treatment within certain timeframes. 

The constitution also outlines the rights and responsibilities of hospital staff, patients and the public and the NHS’s pledges to them. 

For more information on the NHS Constitution and your patient care, please visit the NHS Constitution webpage


  • 1828 — The Royal Free Hospital was founded by William Marsden, a newly qualified surgeon who was shocked he could not find treatment for a penniless young woman. He founded the hospital on the principle that it would provide free healthcare to those who could not afford medical treatment — the first hospital in London to do so.
  • 1837 — The title ‘Royal’ was granted by Queen Victoria in recognition of the hospital’s work with cholera patients (it was the only London hospital to stay open during the cholera epidemics).
  • 1838 — Barnet Hospital first provided healthcare in an infirmary in the Barnet Union Workhouse.
  • 1884 — Chase Farm Hospital began as a home for pauper children.
  • 1887 — The Royal Free Hospital was the first hospital in London to accept women medical students. 


  • 1916-18 — 6,000 wounded and sick soldiers received medical care at Barnet Hospital.
  • 1939-1945 — Casualties of the Second World War are cared for at Chase Farm Hospital under the emergency medical scheme.
  • 1991 — In April 1991, the Royal Free became one of the first NHS trusts. 


  • 2004 — European history is made at Chase Farm Hospital when the first total hip replacement procedure is carried out, with the patient leaving hospital in just 27 hours. At the time, the UK average length of stay was 11 days.
  • 2012 — The hospital was authorised as a foundation trust under the name the Royal Free London NHS Foundation Trust. 
  • 2014 — In July 2014, Barnet and Chase Farm Hospitals NHS Trust became part of the Royal Free London. 
  • 2017 — The Royal Free London group is established, and North Middlesex University Hospital NHS Trust joins us as our first clinical partner. 
  • 2018 — The new Chase Farm Hospital opens, and West Hertfordshire Hospitals NHS Trust joins the group as our second clinical partner.  
  • 2020 — The Royal Free London is one of four trusts to admit the first UK COVID-19 patients. Royal National Orthopaedic Hospital joins the group as our third clinical partner. 
  • 2021 — Chase Farm Hospital is awarded HIMMS level 7, making it one of the most digitally- advanced in the country and one of only four hospitals to receive this accolade.

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Following several years of closer working between North Middlesex University Hospital NHS Trust and the Royal Free London group, we are now planning to come together as one organisation. We believe it would enable us to go further and faster in improving services for patients and improving the health of our local community.

North Mid has been a clinical partner with the Royal Free London group since 2017 and we have been in a formal partnership since 2021. Our experience has shown that we can achieve more together than we can apart, delivering better care for local people and more opportunities for our staff.

We have been developing plans for North Mid to merge into the Royal Free London group alongside Barnet Hospital, Chase Farm Hospital and the Royal Free Hospital. 

Our hospitals would continue to provide the same local services. At North Mid, these include A&E, maternity, intensive care, paediatrics, acute surgery, medicine and community services. 

By coming together as one, we expect to be able to deliver:

  • reduced waiting times
  • improved access to specialist care locally
  • better joined-up community services
  • greater opportunities to benefit from the latest medical research and trials of new treatments
  • more coordinated action to help people stay healthy, with screening and early intervention services tailored to our different communities

Our boards have approved a business case for the merger which will now be submitted to NHS England for approval. It has indicated it will review the business case in autumn 2024. Subject to its approval, and that of the Secretary of State, we expect to bring our organisations together around the end of the year.

Until then, we will continue working together as we do now to provide the best possible care for our patients. 

Further updates will be available here as this work progresses. In the meantime, you can contact us with any queries or comments at

Frequently asked questions

By merging, we aim to improve the quality of services, celebrate the expertise of our individual hospitals and community services, and provide an excellent patient experience.

The range of services provided from each of our hospitals will remain the same, but patients will be treated more quickly and able to access more specialist care in expert hubs, with convenient local follow-up and more joined-up community care. 

There will be more opportunities to benefit from the latest medical research and trials of new treatments and there will be more support to help keep people healthy, with tailored screening and early intervention services for our local communities.

Our hospitals would continue to provide the same local services. At North Mid, these include A&E, maternity, intensive care, paediatrics, acute surgery, medicine and community services.

There are no plans to change the way routine care is currently provided in Barnet Hospital, Chase Farm Hospital and the Royal Free Hospital if North Mid joins the Royal Free London group.

Our plans to come together as one organisation are driven by our shared aim to provide better, more joined-up and sustainable services for our patients and communities.

This is not about cutting costs. Although it will enable us to be more efficient in our use of resources, making the most effective use of our combined budgets. Any savings made will be retained within the organisation to be reinvested in further improved services.

The way healthcare is provided has changed significantly in recent years. Local health and care partners are increasingly working together to tackle shared challenges and to improve health and care for their local populations.
We are proud of what we have achieved already through our partnership, including:

  • improving care through redesigned pathways known as clinical practice groups (CPGs)
  • reducing waiting times and providing more access to specialist treatment and elective care through the establishment of surgical hubs
  • sharing some corporate support services to be more efficient in staffing, estates, facilities, training and research
  • enabling more co-ordinated action on reducing inequalities, environmental sustainability, employment pathways and supporting healthy lifestyles

However, given the scale of challenge that health and care services face, and our shared aim of improving the health of our local communities, we believe that joining together as one will enable us to go further and faster in achieving our ambitions.

No. We have been working in ever closer partnership for several years now and our plans to come together are driven only by our shared aim to improve services for patients and the health of our local communities.
As part of a larger group, we will be able to strengthen and build the resilience of services across all our hospitals by sharing expertise and resources.
Our work to bring our organisations together does not include any plans to reorganise services and is not linked with the Start Well maternity proposals.

Last updated: 8 July 2024

We work with our partners across the North Central London Integrated Care System to ensure our services are patient-focused, based on best practice and good value for taxpayers’ money. 

This includes collaborating with other NHS trusts, primary care, local councils and a wide range of patient groups, such as Healthwatch.

Commercial partners and services

We work in partnership with two wholly-owned subsidiaries of the trust — Royal Free London Property Services Limited (RFLPS) and Royal Free London Dispensary Services Limited (RFLDS) — who offer expertise in their respective areas. RFLPS manages the provision of estates and facilities services to the trust and RFLDS delivers outpatient pharmacy services. 

We provide sterilisation and decontamination services for all our hospitals, other NHS trusts and private hospitals from our state-of-the-art decontamination unit in Enfield. The Chalkmill Drive unit is the biggest and most advanced of its kind in the UK, decontaminating equipment safely and efficiently, 24 hours a day, 365 days a year.

In addition, we provide pathology services to NHS trusts across north central London as part of our venture with The Doctors’ Laboratory and University College London Hospitals NHS Foundation Trust. 

The Royal Free Information Governance Consultancy provides support, assistance and documentation for information governance internally and to other NHS organsiations. You can contact them at

Clinical partners

Through our clinical partnerships, we believe we can achieve more together, to improve health and care for the communities we serve. Our current clinical partners are:

West Hertfordshire Hospitals NHS Trust

Our clinical partnership with West Herts was established in 2018 and has recently been extended to 2025. 

The collaboration involves reducing unwarranted variation in clinical practice and outcomes, successfully implementing a shared electronic patient record and RFLPS supporting West Herts with its successful bids to be part of the national new hospitals programme.

Royal National Orthopaedic Hospital (RNOH)

In 2020, RNOH joined us as a clinical partner. Our joint work on musculoskeletal services has so far helped patients access care more easily and directly reduced the number of people waiting for clinic appointments. 

We are also exploring the potential for digital development and alignment between our organisations. 

Our host services

We host the following clinical and non-clinical services, which provide support to the Royal Free London and other NHS trusts:

Research and education partners