The Department of Health has denied that the impetus behind achieving foundation trust status for all trusts would evaporate after the dropping of the 2014 deadline.

Matthew Kershaw, who is leading the work for the DH, said: “For the vast majority of organisations the momentum that has been built over the past couple of months will not be lost.

“Why would anyone want to go slower than they needed to?”

The government response to the Future Forum paper this week said there was still an “expectation” trusts would be authorised by 2014 but the deadline had been removed.

Mr Kershaw, the DH’s director of provider delivery, said tripartite formal agreements for the process, submitted by SHAs and trusts, that had been agreed by DH would start to be returned to them towards the end of this week.

He said: “The work that we have done thus far suggests somewhere around 20 organisations are going to find it difficult to achieve FT status” – several trusts submitted TFAs with plans to merge.”

His comments appeared to suggest there are several more mergers to come than the proposals that have already been made public - and that some of those that have been revealed might be problematic.

The DH would make public a full list of the agreed plans for all non-FTs to get authorised once the TFAs were agreed, saying this would be in a “couple of months”, he added.

Mr Kershaw also confirmed that the 116 trusts who have not achieved foundation status by April 2014 could see a private franchised management.

He told HSJ: “We are doing work around the intervention model which might be NHS, independent sector or a combination there-of. Over the next few months that work will conclude.”

News is expected in the next fortnight on whether Circle will be allowed to take over management of Hinchingbrooke Health Trust in Cambridgeshire. The Treasury has yet to sign off the transaction.

A strategy director at one non-FT trust said there was no doubt the situation around FT authorisation had changed since the the TFAs were submitted in March.

He said: “The ‘pause’ has very much thrown into doubt whether hiving [management] off to the private sector is politically acceptable. The immediate pressure on hitting the deadline has clearly gone.

“This was the DH and the government having to accept reality as they had a fair number of TFAs that weren’t worth the paper they were written on, file under ‘fiction’. The DH knew it, the SHA’s knew it and so did the trusts themselves.”