The survival of Oxford's Nuffield Orthopaedic Centre as an independent health trust has been dealt a major new blow. The world famous specialist hospital may see its services taken over by private companies or another NHS Trust, as worrying options for its future were spelled out. Hopes that the NOC might be allowed to continue as an independent organisation were all but dashed by news that it cannot bid for foundation trust status.

It was deemed not to have the "financial stability" to go forward, and faces being merged with a bigger trust or private health provider.

NOC chief executive Jan Fowler said: "The South Central Strategic Health Authority has determined that the NOC does not have a financially viable future as an independent organisation."