So what does the slackening off of the pressure behind the foundation trust pipeline mean for London, the most stubborn of regions in resisting an all-FT health service?

It will largely depend on whether the centre can hold trusts to the dates they gave for applying to Monitor in their tripartite formal agreements. “Largely” because the deadlines keep slipping on trusts declaring a target date for application.

The 2014 “drop-dead” date did encourage movement on this front where there might otherwise have been none, HSJ has been told.

Epsom and St Helier has now named its favoured suitors, for example St George’s could take more time to digest St Helier.

But St George’s decision to put back its solo FT application to April 2013 last month and the subsequent departure of its respected chief executive and chair weren’t a ringing endorsement of the drop-dead policy.

Long-heralded ideas like the Barnet and Chase Farm/North Middlesex merger might also be easier to achieve without a blanket deadline.

The Royal National Orthopaedic Hospital, a trust with financial problems, has identified four options for its future, only one of which was staying independent. Could that option be more realistic now there are more than 34 months to get there?

There’s still no answer on petite West Middlesex University Hospital’s FT plans, although a consultancy tender has gone out to consider its options alongside troubled behemoth Imperial College Healthcare.

The hospital disinvestment plans from the London clusters outline quite a painful story for trusts over the next four years.

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