STRUCTURE: Monitor has launched a review of health services in Bedfordshire and Milton Keynes in an attempt to avert “significant problems ahead” at two hospitals.

The regulator will work with Bedfordshire and Milton Keynes clinical commissioning groups, NHS England and the NHS Trust Development Authority to devise a sustainable future for Bedford Hospital Trust and Milton Keynes Hospital Foundation Trust. It is hoped this will avoid Monitor having to impose a solution.

Monitor interim senior enforcement director Jonathan Guppy said the regulator was overseeing the review because it had “more experience in coordinating pieces of work of this nature” than the CCGs which “are new, and this is going to be a complex piece of work”.

Mr Guppy said Monitor had “done nothing quite like this before”, even if it was within its remit.

“To do nothing is not an option,” he added, as “there are significant problems ahead unless some fundamental issues are addressed”.

“It’s certainly different from some of the actions that you’ve seen us take recently,” he said. “This is not a Peterborough or a Mid Staffs-type situation. We’re not looking at using similar powers as we used there.”

Monitor has ordered Peterborough and Stamford Hospitals Foundation Trust to implement a recovery plan aimed at closing its £40m annual financial gap and appointed special administrators to determine the future of Mid Staffordshire Foundation Trust.

Bedford’s annual audit letter, published in August, warned of “significant challenges in 2013-14 to find a solution that enabled it to be sustainable into the future”.

Milton Keynes Hospital Foundation Trust has faced similar financial problems. It ended 2012-13 with a £8.8m deficit and was also one of 26 foundation trusts to trigger a risk summit.

The review came about after both CCGs wrote to Monitor for assistance. Paul Hassan, Bedfordshire’s clinical chair, said Monitor was better able to fund the review than the CCGs and “financially, to do the review on our own would be impossible”.

Bedford has previously expressed an interest in merging with Milton Keynes. However, Dr Hassan said: “We certainly are not going into this believing that that will end up as the preferred option - we are not going to prejudge it.”

The review is due to start in early December. It is due to finish in summer 2014.