A £145m-turnover district general hospital is the latest to concede it cannot become a foundation trust on its own and look for a merger partner.

Bedford Hospital Trust is today inviting expressions of interest from foundation trusts to merge with it, ruling out private franchise management bids, like the one operated by Circle at Hinchingbrooke Health Care Trust in Cambridgeshire, or mergers with other aspirant FTs.

Former health secretary Andrew Lansley’s policy was for all trusts to attempt to achieve foundation status by April 2014, although it was acknowledged some would not make this until 2016.

The news from Bedford comes as non-foundation trusts find it increasingly difficult to pass Monitor’s authorisation tests.

In July, Barnet and Chase Farm Hospitals Trust, which has a turnover of more than £300m, announced it was seeking expressions of interest for a merger partner.

Bedford is one of five in the NHS Midlands and East Strategic Health Authority area participating in a clinical services review to assess the viability of the health economy.

The strategic health authority refused HSJ’s Freedom of Information Act application to obtain a report by consultants KPMG into the work across Luton and Dunstable Hospital Foundation Trust, Milton Keynes Hospital Foundation Trust, Northampton Hospital Trust and Kettering General Hospital Foundation Trust.

HSJ understands the review of clinical networks across the area outlines a scenario in which Bedford loses services to its neighbours.

The deadline for expressions of interest in a merger is 19 September.

Likely contenders are thought to be Luton and Dunstable, Milton Keynes or Kettering, but HSJ understands pairings with Cambridge University Hospitals Foundation Trust or mental health trust South Essex Partnership Foundation Trust are not out of the question.

The trust’s tripartite formal agreement, signed with the SHA and Department of Health last September, committed it to submitting its foundation trust application to the DH next month.

Bedford chief executive Joe Harrison said: “This exercise is designed to test whether there is interest among foundation trusts in forming a partnership with Bedford Hospital to ensure sustainable, high quality acute health services for local people now and in the future.

“We are in the really fortunate position of being able, with local people and stakeholders, to control and manage how Bedford becomes an FT – which it has to do under current national requirements – because our clinical and financial performance is good. That good performance means that we are in a strong position to form a partnership with another organisation, and has meant that we can discount other options, like a private operating franchise, at this stage.

“Although our performance is strong, we now know we cannot proceed to NHS FT status alone because we lack the necessary clinical critical mass and long-term financial viability, due to our size. In meetings with stakeholders, which have included staff and patient representatives, we have gone through all other opportunities for achieving NHS FT status and determined that a partnership with an NHS FT is the preferred option.”