Hospitals in Birmingham and the Black Country have launched consultations on their applications for foundation trust status.
Heartlands, Solihull, Sandwell, West Birmingham, Birmingham Women's and Walsall NHS Trusts were all recently successful in their preliminary application to be part of the second wave to establish NHS Foundation Trusts in England.
If they succeed in their final application to the independent regulator, they will be established as foundation trusts in October.
Together with University Hospital Birmingham NHS Trust, which is due to achieve foundation status in July, Birmingham and the Black Country could have five NHS Foundation Trusts, the second highest number for any Strategic Health Authority area.
Foundation status will give hospitals freedom to run their own affairs while remaining within the NHS.
