Five more NHS trusts have been granted foundation status, taking the total in England to 25.
Some trusts have run into trouble
However, four other trusts who were up for consideration have not been given the go ahead.
Monitor, the independent regulator, has deferred consideration of two applications, and two other trusts have withdrawn their bids for further work.
Foundation trusts have more freedom to control their own finances, and the way they develop services.
The two deferred applications were submitted by Southend Hospital NHS Trust and West Suffolk Hospitals NHS Trust.
New NHS foundation trusts
Barnsley District General Hospitals
Chesterfield and North Derbyshire Royal Hospitals
South Tyneside Healthcare
Monitor has said it may take a further decision on both trusts at a later date.
The two applicants that withdrew - Nottingham City Hospitals NHS trust and Burton Hospitals NHS - said they planned to re-apply in the future.
Stephen Humphreys, director of communications for Monitor, told the BBC News website: "All those involved in the process are gaining a much better understanding of what is required to become a foundation trust, and have recognised that it is quite demanding.
"Trusts need to be able to manage their own affairs, be well governed and financially viable - that is all quite challenging."
The government wants all NHS trusts to be in a position to apply for foundation status by 2008.
However, last month Monitor removed the chairman of Bradford Teaching Hospitals NHS Foundation Trust, after it ran up millions of pounds of debt.
Other foundation trusts have also had to agree plans with the regulator to boost their performance, amid concerns about the difficulty of making the transition from central control to running their own affairs.
Sue Slipman, director of the Foundation Trust Network, said that tougher financial circumstances were making it more difficult for hospitals to apply for foundation status.
Of particular concern was the government target to have 15% of hospital patients treated in new private-sector diagnostic and treatment centres, which diverted routine work away from NHS trusts.
Former health secretary Frank Dobson called for foundation trust project to be scrapped.
He told the BBC Radio 4 World at One programme:"The policy should be reversed because the whole concept of trying to raise standards by introducing competition between different parts of the NHS is stupid and damaging."
At current rates, it would be 20 years before the Government achieved its
target of granting all NHS trusts foundation status, he said.
Health Minister John Hutton said: "I'm delighted that five more hospitals can enjoy foundation status.
"Today's announcement marks a further step on the road to decentralisation, freeing up more of the NHS from day-to-day Whitehall control and giving local patients more power to influence local services."
Mr Hutton said foundation trusts were making clear improvements in the quality of care for their patients.
"The new status has in effect given NHS Foundation Trusts the freedom to think differently, and they have been using their new capital and management freedoms to respond much more quickly to the needs of their patients."
Shadow Health Secretary Andrew Lansley said the foundation hospital policy was "piecemeal and restrictive".
"Labour have put Foundation Trusts in a bureaucratic straitjacket. The overwhelming majority of Foundation Hospitals need greater freedom if we are to see the NHS innovate, expand and respond to patients' right to choose."
In total, 20 trusts were given the go ahead to pursue foundation status last July. A decision on the second batch of those applicants will be made in April.