STRUCTURE: A London hospital trust chief executive has stepped down, saying the trust board’s decision to delay its foundation application “has led me to consider my position”.

St George’s Healthcare Trust has had to put back its application twice, slipping from January 2010 to November 2010.

HSJ reported yesterday that It had recently delayed it again to April 2013, and is now one of only seven in England setting such a late application date.

Trusts have an April 2014 deadline for achieving foundation status, with the implicit possibility of privately franchised management,as proposed for Hinchingbrooke Hospital in Huntingdon.

David Astley joined the south London organisation in December 2006 and oversaw its absorption of Wandsworth Primary Care Trust’s provider arm and the establishment of a hyper acute stroke unit and major trauma centre.

In a statement he said: “I had always planned to retire from the NHS when I reached the age of sixty which is now just two years away. The board’s recent decision to delay our Foundation Trust application to April 2013 has led me to consider my position.

“It is important that the trust has a chief executive who can drive the organisation forward to achieving its goals for 2013 and beyond. Therefore I have taken the difficult decision, in the long-term interests of the trust, to step down. I am immensely proud of what has been achieved during my time at St George’s Healthcare although none of this would have been possible without the support, hard work and dedication of colleagues from across the organisation.”

The £560m turnover trust has been talked about as a key regional player and a possible merger partner in the struggle to get Epsom and St Helier and Kingston Hospitals trusts authorised.

St Georges was given an £8m bail-out from NHS London’s Challenged Trust Board last year and recently saw protests after job cuts were announced.

The news comes after Monitor faced claims they were raising the bar for aspirant trusts by revising the efficiency assumptions for trusts up to a “worst case” scenario of six per cent. St George’s has set a 7.5 per cent cost improvment plan target for 2011-12.

Trust chair Naaz Coker said: “On behalf of the trust board I would like to thank David for the valuable work he has done over the past four years. David has decided to step down now to allow a new leader to take St George’s forward as a foundation trust. David is very well respected by his colleagues and will be missed at the trust and we all wish him well for the future.”

NHS London chief executive Ruth Carnall said: “David’s leadership over the past four years has been instrumental in the transformation of many of St George’s services. The trust is now amongst the best in the country for its care of stroke patients, heart disease and major trauma. With his support, a number of the trust’s leading doctors have also been involved in clinically-led reforms to improve health services across the capital.“

The trust has started the process of appointing a new chief executive and, in the meantime, Patrick Mitchell, chief operating officer, will act up in an interim capacity.