Hospital trusts in London and Yorkshire have reached the point of no return, without hope of reaching Foundation Trust status in their current form.
South London Healthcare NHS Trust has gone into administration after running up deficits of more than £150m.
Mid Yorkshire Hospitals NHS Trust has seen its deficit increase in a year from £19.2m to £44.2m, and is considering options for service closure.
Over 20 hospital trusts are struggling to meet Foundation Trust criteria by the 2014 deadline and find a place in the new provider landscape.
The first NHS trust to go into administration, South London Healthcare was formed in 2009 from the merger of three NHS hospitals with a joint deficit of £21m.
The trust serves more than a million people in the capital. Despite saving £41m in 2010–11, it ended the year with a £41m deficit which has since escalated.
Mid Yorkshire Hospitals Trust, which also comprises three hospitals, is considering two options to halve its current £44.m deficit by April 2013.
The trust said it would “not be in a position to progress to Foundation Trust status in the foreseeable future”.
Stephen Eames, the trust’s Interim Chief Executive, said: “The challenges faced by the trust have been a matter of public concern for many years.”
Two options were on the table, he said, both with the aim of immediately reducing the deficit: “The first looks at doing what we must do to make services clinically safe and sustainable, whilst the second goes further, radically reorganising services across our hospital sites to make the best use of resources.”
The first option would include consolidating children’s and maternity services in Wakefield, while the second would bring all emergency and complex services into the Pinderfields hospital.