Of more than 100 NHS hospital trusts that have not achieved Foundation Trust status, only a third will do so, according to the King’s Fund.
The health think tank warned that ‘mergers’ with more financially robust trusts, the current most popular solution, will rarely be feasible.
The problems of making acute care services sustainable in FT terms are “systemic” and not caused by individual hospitals, said Candace Imison, King’s Fund Deputy Director of Policy.
Speaking at an event titled ‘NHS Providers: is Bigger Better?’, Imison observed that more than 100 of 248 trusts required to achieve FT status had not yet done so.
She warned that “the FT pipeline has almost dried up”, with only 14 FT authorisations in the last two years.
“The NHS Trust Development Authority reckons that only about a third of the current pipeline might proceed in their current form,” Imison noted.
The National Audit Office has predicted that 20 hospital trusts will not achieve FT status by 2014, and Imerson said that 17 of these have declared an intention to merge with bigger trusts.
However, she added, “the evidence is not great about mergers”, and other solutions – takeovers, franchises or shutdowns – were more likely.
Franchising by a private hospital chain such as Circle might be the most realistic option, Imison said.
Finally, she noted: “There is a real risk that we treat failure as a single organisational problem when the issue may well be a lot more systemic and linked to the overall configuration of services in a patch.”
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