The consequences of the Francis inquiry into the Mid Staffordshire care scandal have pushed back the process of getting all NHS providers to foundation trust status by two years, David Flory has told HSJ.

Mr Flory is chief executive of the authority responsible for shepherding the remaining NHS trusts through to authorisation by FT regulator Monitor. He said the safeguards required to ensure organisations were not endangering patient safety in order to attain FT status had added two years to the time it would take to get all trusts authorised.

He said he did not want to “take our foot off the pedal” but conceded there were “lots more things on a broad scale that we need to get right before we put [applicant trusts] forward.”

Former health secretary Andrew Lansley originally ordered all trusts be authorised by April 2014, a target that has since been dropped.

Mr Flory noted multi-site hospital trusts appeared to have some of the greatest challenges, saying: “The evidence that we have seen shows [that for] some of the organisations that have struggled the most, the clue is in the title: Heatherwood and Wexham Park, Stafford and Cannock.”

However, he added he was talking to some trusts about bringing forward their applications, as they were on track to be ready before their planned dates.

Mr Flory, who is responsible for finding organisational forms for trusts that will not become foundations on their own, also indicated he expected to see at least one more Hinchingbrooke-style private management franchise in the NHS before the next election. He told HSJ he would be “quite surprised” if there had not been another such deal in the next two years.

Private operator Circle began a landmark 10-year contract to manage Hinchingbrooke Health Care Trust in February 2012. Three trusts are currently known to be considering similar management franchise deals, among other possible options.

The three are Wye Valley Trust, George Eliot Hospital Trust and Weston Area Health Trust − all relatively small organisations with different levels of integration with local community services.

In chastening news for the 18 aspirant community foundation trusts created in 2010 by the transforming community services programme, Mr Flory told HSJ: “Do I think every community provider in the pipeline will become an FT? Probably not.”

But he added: “I think there will be some community FTs.

“Commissioners are taking a keen interest in community services in many areas.”

Flory: 'Loss of experience is greater than I’ve seen'