The NHS will face significant political opposition to attempts to eliminate all non-foundation trusts.

HSJ asked MPs and council health scrutiny chairs with trusts not expected to achieve foundation status in their constituencies if they were likely to support potential changes. Of the 17 who responded, most rejected all likely outcomes for the trusts - being merged or acquired, closing services, or being franchised.

The results demonstrate some of the barriers facing the government and managers in addressing the future of trusts considered unsustainable and have been met with calls for flexibility in the December 2010 deadline for applications.

Around 20 trusts are expected not to achieve foundation status.

Closing services to make the trust sustainable and being franchised by a private company were the least popular options with councillors.

Options are ‘lunatic’

But the prospect of trusts being acquired by another NHS organisation or having board members replaced were also rejected by 71 per cent of respondents.

Several MPs said they rejected all the options for their trust.

Former health secretary Frank Dobson, whose constituency is Holborn and St Pancras in London, said: “All the options set out are absolutely lunatic and no one in their right mind would want Great Ormond Street to be anything other than to continue as is it as Britain’s leading children’s hospital.”

Northavon Liberal Democrat MP Steve Webb said North Bristol trust should be allowed to “get on with being an NHS hospital instead of wasting their time worrying [about] being a foundation trust”.

Away from consolidation

Barnet and Chase Farm Hospitals trust chief executive Averil Dongworth said the trust was still expecting to achieve foundation status.

She said: “Mergers should happen if trusts need to come together for good business reasons. I don’t believe in forcing management mergers.”

NHS Confederation policy director Nigel Edwards said another barrier may be successful trusts or foundations not wanting to acquire less successful organisations. Strategic health authorities should treat the December 2010 deadline with a “degree of subtlety” as some could become foundations later, he said.

However, NHS East of England director of strategy Stephen Dunn said his region had set its pipeline deadline at the end of this year.

“It gets to a point when you say current boards have not been able to deliver the turnaround in performance,” he said.

OptionsLikely to support or neutralLikely to opposeNot answered
Merge791
Be acquired5111
Split7100
NHS franchise6110
Private franchise5120
Close services5120
Board removals5111