Documents released by the Department of Health show five foundation trusts where reconfiguration of services could be necessary.

Peterborough City Hospital

Monitor applied for £33.5m in revenue funding for Peterborough and Stamford Hospitals

Peterborough City Hospital

The Independent Trust Finance Facility is a committee of the DH and considers requests from trusts and their regulators for capital or revenue funding. Its members make their decisions based on the strategic and financial position of a trust.

Minutes of the ITFF’s meeting in August, released last month, show the committee recorded that there were five trusts across the country for which Monitor asked for funding to reconfigure services.

Northern Lincolnshire and Goole Hospitals

The trust “aims to have a reconfiguration plan in place within 12 months”, the minutes said. In its application, Monitor said the team working to close the local health economy’s funding gap “envisages radical reconfiguration of services”.

Monitor submitted a bid for £19.7m in funding to the ITFF on behalf of North Lincolnshire and Goole in August.

Monitor said: “The main drivers to the deficit include structural cost pressures relating to the trust’s three-site configuration and increasing agency costs as a result of recruitment challenges experienced across the North East”.

It added that a longer term strategic plan was expected this year and that it would “require radical reconfiguration of services [so] will be subject to extensive public consultation”.

University Hospitals of Morecambe Bay

At University Hospitals of Morecambe Bay in Lancashire “in the longer term it seems likely that services will be concentrated on the sites in Barrow and Lancaster, rather Kendal”.

Monitor submitted a £42.9m bid on behalf of the trust. As part of the application the regulator said the local reconfiguration programme would “retain district general hospital services, notably obstetrics and accident and emergency services, in Barrow-in-Furness and Lancaster”. The trust also has a hospital in Kendal.

The regulator said “a significant transaction is scheduled to be undertaken by Monitor in early 2016”, although whether this would involve a merger, acquisition or another process is unclear.

Queen Elizabeth Hospital Kings Lynn

At QEH Kings Lynn in Norfolk “there may need to be a rationalisation of services because of the geography and the current levels of activity”.

The application on behalf of the trust said the trust planned to focus on internal efficiency targets at first “but it will then need to address the local health economy pressures within the next 18 months. There may need to be a rationalisation of services because of geography and the current levels of activity”.

A report from a Monitor contingency planning team last year said £28m in savings were possible within the trust and the health economy but work was continuing on a further £12m that would be necessary to avoid deficits over the longer term.

Colchester University Hospitals

The Essex FT will need to be part of the “wider longer term sustainability plan required in the east coast region”.

However, the regulator’s application also said the first priority was internal efficiency savings.

Three trusts in south Essex are already part of the “success regime”, which is looking at the configuration of services and organisations.

Peterborough and Stamford Hospitals

Regarding Peterborough and Stamford Hospitals’ future, the ITFF said “much depends upon a potential reconfiguration of capacity around Cambridge”.

Monitor’s application for £33.5m in revenue funding reveals “system-wide work is under way to review patient flows and options for reconfiguring services, which is being led by local commissioners”.