STRUCTURE: Sir David Nicholson has written to the board of a strategic health authority saying “there is a real danger that by the end of 2011-12 many of these [trusts in the pipeline] will be a position where their ability to achieve FT by 2014 will have worsened”.

The comments came in a letter after a “transition assurance visit” from the NHS chief executive in May.

Sir David said: “The picture we see in London is the most challenging FT pipeline in the country. Some of the trusts face extremely ambitious time scales for achieving FT status as well as having financial and service reconfiguration issues to resolve.

“Bilateral discussions between the Department of Health and the SHA regarding the most challenging cases are planned and are key to agreeing plans and a way forward for each trust.”

The news comes after the former head of provider development at NHS London Mark Davies said “roughly half” of the capital’s non-FT acutes would “require mergers, service reconfigurations (or both)”.


Known merger/reconfiguration bids include:

Barts and the London, Whipps Cross and Newham University Hospital Trusts.

Ealing Hospital and North West London Hospitals Trust.

Epsom and St Helier have seen St George’s bid to absorb their Sutton facilities.

West Middlesex University Hospital and Imperial College Healthcare Trust have commissioned consultants to examine their options for getting to FT status together.

The Royal National Orthopaedic Hospital options for becoming an FT include merger or a private franchise.

MPs have called for North Middlesex Hospital and Barnet and Chase Farm trusts to merge. A reconfiguration proposal is being considered by the Independent Reconfiguration Panel.

Barking, Havering and Redbridge Unviersity Hospitals Trust and South London Healthcare Trust both have significant service reconfigurations with the IRP.