The Department of Health has re-iterated that if trusts miss their targets for applying for foundation trust status they face an “escalation process”.

Trusts signed tripartite formal agreements with the DH and strategic health authorities in September 2011 which agreed a number of milestones by which time they would have completed parts of the application.

In a circular released to the service today the DH said each trust was being given a monthly red, amber or green rating, dependent on their progress. Three consecutive red ratings or failure to achieve the application date would trigger the “escalation process”.

As HSJ reported at the start of March, within three months of the TFAs being signed 18 of the 116 trusts in the foundation trust pipeline had already missed the target or were considered at risk of doing so.

A confidential report by DH director of provider delivery Matthew Kershaw and obtained by HSJ set out the “escalation process” and named three large teaching hospitals that had been forced to delay their submission date: Coventry and Warwickshire, Leicester and Croydon.

The circular did not set out what the “escalation process” involved but HSJ reported earlier this month that Mr Kershaw had proposed the trusts in question take “additional support [which] means a loss of autonomy for the organisation and implications for board leadership”.

The circular released today said there were now 17 trusts subject to the escalation process.

The document also said: “Work is also underway to bring together the department’s performance framework and the TFA monitoring to streamline these two processes. This will go live from April 2012.”

A DH spokeswoman said the department would not reveal who the 17 ‘escalated’ trusts are.