A hospital in Norfolk has had its application for foundation status approved by the government. Foundation status would allow The James Paget Hospital, in Gorleston, to make more decisions, including setting its own pay scales.
The application will go forward to an independent regulator, which will make the final decision in April.
If approved the hospital would become the first NHS Foundation Trust in Norfolk and Suffolk.
David Hill, chief executive, said: "Our Trust Board will use the status to ensure we deliver the high quality services that our population requires."
A further 17 NHS trusts are bidding for foundation status.