A dozen trusts likely to win through

Up to 20 trusts are likely to express an interest in foundation status after a meeting of chief executives of three-star trusts, scheduled for the end of this month.

Six trusts already look to be definite candidates, according to HSJ sources, and the first wave of foundation hospitals is likely to total a dozen.

Trust chief executives contacted by HSJ have made it clear they are looking for further detail on how foundation trusts will work, expected to emerge at the meeting on October 29, and must formally seek the approval of their boards.

Likely candidates are University College London Hospitals trust, University Hospital Birmingham trust, Addenbrooke's trust, Peterborough Hospitals trust, Sheffield Teaching Hospitals trust and Walsall Hospitals trust.

UCLH chief executive Robert Naylor said that although the trust board had not discussed an application of interest, details emerging from Downing Street last week had made the situation clearer.

He said: 'I think this is very sensible. It gives a clear way forward without any political obfuscation - which there was.

'We have to do this within the whole health economy, and I am keen that we need to see this in the context of opportunities for everybody else.

'I suspect out of the 40 or so [three-star trusts], we will end up with 10 [foundation trusts] at the end of the process.'

Mr Naylor said the issue was not whether borrowing was on or off the balance sheet, but about the ability to show a revenue stream sufficient for borrowing.

He said: 'We need to have longer-term guaranteed contracts with commissioners, which we do not have. They are not legally enforceable at the moment.'

On stakeholder councils, Mr Naylor said: 'The last thing we want to do is free up trusts... and replace them with another set of bureaucracy.'

Addenbrooke's director of information and planning Stephen Davies said the trust was interested, but needed further detail: 'How far are foundation trusts going to be sure that if they do extra work, they get paid for it?

'The government believes the financial flows will deal with this.

I think it remains to be seen, because commissioners operate within fixed budgets. The experience within the internal market lies behind this. In the end, contract mechanisms tended to leave the risk with providers.'

On the stakeholder council, he said: 'The crucial issues are going to be the balance between the stakeholder council and the board, and the composition of the stakeholder council.'

Walsall Hospitals trust chief executive John Rostill said: 'We remain excited about the prospect and are continuing to pursue the possibility.'

He said the board would make a decision after the meeting of three-star trusts at the end of this month.

'It is places like this, grossly underfunded and definitely understaffed, with low management costs and pretty good at hitting targets that can take advantage of foundation status.'

Peterborough Hospitals trust and Sheffield Teaching Hospitals trust both said they were interested in foundation status but wanted to find out more.