Published: 30/05/2002, Volume II2, No. 5807 Page 5

Four trusts have put themselves forward to become part of the first wave of foundation hospitals.

Northumbria Healthcare trust, Peterborough Hospitals trust, Norfolk and Norwich University Hospital trust and Addenbrooke's trust have all expressed an interest. But a senior NHS source said it was not guaranteed all four would end up in the first wave of foundation trusts when they are announced - either because they opt out of the process or they fail to make the grade.

HSJ understands four more trusts were also due to be on last week's list, but were pulled at the last minute because they did not have three stars.

To bid for foundation status, trusts will need to get three stars in July. They will also have to show they have support from local primary care trusts and the management capability and clinical support to make a success of their new status. Guidance on the criteria for assessment and how to apply will be set out in the summer.

The first trusts will be chosen this autumn, with the first wave due to start operating in shadow form next April. Fresh legislation will be required to formally set up foundation trusts as independent, not-forprofit bodies. Regulation will be taken on by the new Commission for Healthcare Audit and Inspection rather than the DoH.

Health secretary Alan Milburn laid out the plans at a London seminar on the European experience of running hospitals as independent institutions, with guests from three-star English trusts, and officials and managers from hospitals in Sweden, Spain and Denmark.

Mr Milburn said a number of models for staff and public involvement were being explored, including one involving lay people sitting alongside hospital staff, local businesses, local authorities and university lay governors.

Under that model, a separate board including the chief executive would have responsibility for day-to-day management. The health secretary is also looking at the potential for direct elections of patient representatives.

Carola Lemne, chief executive of Danderyd University Hospital in Sweden, said its status as a company owned by the city council allowed it the management freedoms to set pay levels and staff contracts. But she said in practice, as one of four university hospitals in Stockholm, 'we have to look at this not as a free-standing corporation, but as a conglomerate'.

Ms Lemne pointed to very good standards of service in many areas, including a 13-day wait from diagnosis to operation for breast cancer.