Nearly 50 NHS trusts are likely to face merger or franchised management as they are unable to gain foundation status in their current form, HSJ has learned.
Of the 99 NHS hospital, mental health, community and ambulance providers which have yet to become foundation trusts, nearly half will be unable to do so as independent organisations, according to the authority responsible.
The NHS Trust Development Authority, which is responsible for managing trusts and preparing them to become foundations, has confirmed to HSJ that only 52 would have a “standalone solution”.
That leaves 47 which do not.
The total is significantly higher than previous estimates of how many trusts would not become foundation trusts, which put the number at around 20.
There are 19 trusts across England where a merger has either been agreed or proposed with another trust, or where use of the failure regime has been discussed. This suggests a further 28 trusts which have not yet been identified will not be able to continue in their current form.
Sixteen trusts have already been referred to Monitor for consideration. Some, such as Kingston and West Sussex Hospitals, are expected to be authorised shortly, although others may have their applications deferred for up to a year.
The remainder have either submitted an application to the NTDA for a decision on their future; are due to submit it soon; or have doubts over their future independence.
However, one senior source said the political appetite for using the failure regime legislation had dwindled in recent months.
Read the full briefing on the FT pipeline here.
The revelation that 47 trusts are very unlikely to have an independent future appears to indicate many of the 18 aspirant community foundation trusts will not be authorised.
They are widely considered to be vulnerable to competition, and among the most likely to be taken over.
Cambridgeshire Community Trust is in the process of being split up after commissioners said they would not support it as an independent FT.
Sussex Community Healthcare Trust told HSJ it was awaiting the result of discussions with the NTDA about whether it had a standalone future. Its services may be taken on by Sussex Partnership Foundation Trust or Western Sussex Hospitals Trust.
However, there is a possibility that a change in rules under consideration by Monitor could improve community trusts’ prospects. The regulator is considering a change in the way it assesses organisations’ financial risk, which would remove consideration of the value of their assets – something which has so far disadvantaged community trusts.
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Exclusive: Nearly 50 trusts 'have no independent future'