Seven NHS and university partnerships remain in the running to become 'super-trust' academic health science centres.
As groups reach the second stage of the accreditation process, one trust has confirmed it plans to merge with its partner in a centre.
Nuffield Orthopaedic Centre trust will merge with Oxford Radcliffe Hospitals trust, and will together work with Oxford University.
Nuffield chief executive Jan Fowler said: "We are looking at [Oxford trust] becoming a foundation trust and at the right point Nuffield becoming a part of that."
The trust was identified by NHS South Central as its only provider not expected to gain foundation status by the December 2010 deadline.
Ms Fowler said it was forecast to break even this year and had met targets but wanted to merge to strengthen the science centre. "It is about getting the right level of balance between integration and ensuring the trust retains its brand."
Ms Fowler said a change in the law to allow new forms of NHS organisation for science centre partnerships was possible, but not expected in the near future.
Academic health science centres focus on translating breakthroughs into clinical practice. The next stage review said they should be extended.
Groups applying for accreditation vary widely in size and makeup and are planning different degrees of integration. An international panel will judge them on governance, among other areas, at interviews early next month.
King's Health Partners
King's Health Partners interim director Robert Lechler said its member trusts did not plan to merge but would integrate all areas of their work, including their business plans.
"What we are doing is more intelligent [than merging]," Professor Lechler said. "If you merge two trusts you don't get an AHSC, you get a very big trust."
All elements of governance will be brought together through joint management groups which, he said, "is actually going quite a long way down the path" to merging.
Great Ormond Street Hospital for Children trust, which like Nuffield was not expected to gain foundation status by the deadline, said it did not plan to merge with University College London Hospitals foundation trust. "[The trust] wants to become a foundation trust and believes that remaining independent is in the best interests of our patients." UCL Partners was "not pursuing a structural merger between partners", a spokeswoman said.
THE SEVEN PARTNERSHIPS STILL IN THE RUNNING
Birmingham AHSC Birmingham University; University Hospitals Birmingham, Heart of England, Birmingham Children's Hospital, and Birmingham Women's foundation trusts; Sandwell and West Birmingham Hospitals trust; South Birmingham PCT; Heart of Birmingham teaching PCT
Cambridge AHSC Cambridge University; Cambridge University Hospitals, Papworth Hospital, and Cambridgeshire and Peterborough foundation trusts
Imperial AHSC Imperial College London; Imperial College Healthcare trust
King's Health Partners King's College London; Guy's and St Thomas's, King's College Hospital, and South London and Maudsley foundation trusts
Manchester AHSC Manchester University; Central Manchester University Hospitals, Christie Hospital, Salford Royal, and University Hospital of South Manchester foundation trusts; Manchester Mental Health and Social Care trust; Salford PCT
Oxford AHSC Oxford University; Oxford Radcliffe Hospitals and Nuffield Orthopaedic Centre trusts
UCL Partners University College London; University College London Hospitals and Moorfields Eye Hospital foundation trusts; Great Ormond Street Hospital for Children and Royal Free Hampstead trusts