The recession is being cited as a cause for further delays in trusts gaining foundation status.

Two documents published by Monitor have referred to the impact of the downturn and one trust has blamed the economic climate after it withdrew its application.

The regulator's draft corporate plan says: "The government is aiming to accelerate [the process]. As the financial environment becomes increasingly challenging we expect that later applicants could be less prepared to meet the standards we set for authorisation."

Monitor says it will ensure foundations are "capable of managing the responsibilities and pressures which come with greater autonomy".

Withdrawn

Last week Portsmouth Hospitals trust announced it had withdrawn from the process, claiming uncertainty caused by the recession had "left our local health economy in a difficult position".

In November the trust reported an in-year deficit of£976,000 against a planned£1.1m surplus.

King's College Hospital foundation trust chief executive Tim Smart said it would get harder for trusts to pass the conditions set by Monitor.

He said in a more competitive marketplace, "maintaining a level of financial sustainability is not going to get any easier".