More than half of the Department of Health’s seven financially “challenged” trusts appear to have abandoned plans to become foundation trusts.

An NHS Richmond and Twickenham board document says West Middlesex University Hospital Trust has “indicated that it is not possible to develop a sustainable application and will not be progressing to an independent FT application”.

West Middlesex University Hospital Trust told HSJ the board was yet to make a decision.

But if it does abandon its foundation status plans, this would leave significant uncertainty hanging over the future of four of the seven trusts labelled “challenged” in the DH’s latest quarterly report.

Of the other “challenged” trusts, Trafford Healthcare announced in December it would look to merge with a neighbouring foundation. North West London Hospitals Trust is contemplating a merger with Ealing Hospital Trust and the three local PCT provider arms.

NHS London is due to consider plans to merge Whipps Cross University Hospital Trust with either Homerton University Hospital Foundation Trust or Barts and the London Trust at the end of this month.

The other three trusts are Barking, Havering and Redbridge University Hospitals, South London Healthcare and Portsmouth Hospitals, all of which have large private finance initiative agreements, which observers fear could undermine their foundation trust applications.

The news about West Middlesex comes a week after NHS chief executive Sir David Nicholson told a parliamentary committee the DH had identified 21 trusts that will struggle to achieve foundation status.

HSJ also understands the plan to move the Royal National Orthopaedic Hospital onto the West Middlesex site has been abandoned. As a specialist trust, its location is deemed to be less significant than if it were a general hospital.

The trust last month advertised for a PFI partner for a £90m rebuild.