Atlantis Medical News

Concerns over true cost of NHS Trust mergers

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13 FEB 2019

Given the pressure on the NHS, it is understandable why some people suggest merging NHS Trusts in order to save money and provide better value for money. Cutting costs is essential in the modern day NHS but making changes to the National Health Service cannot be carried out in the same way that a standard business would.

After all, there are lives at stake and in the new analysis carried out by the Competition and Markets Authority, there is genuine concern that if hospital trusts are merged, mortality rates could increase by up to 550%. There is also the fact that patient harm incidents could triple. These are not outcomes that anyone would wish for, which means that there must be serious consideration made as to whether NHS hospital trusts can be merged.

The study also highlighted a potential cost of over £2.5m a year in dealing with harm caused by a merger of hospital trusts.
People could be put at risk with these changes

The Chief Executive of the Nuffield Trust, Nigel Edwards, spoke to the HSJ in an attempt to calm fears about these figures, saying; “The conclusion that says a merger will increase death rates is completely illegitimate and an overextension of the analysis because there are other factors driving this.”

As you would expect, the CMA supported their claims, releasing a statement, saying; “We find a significant inverse relationship between concentration and quality. A hypothetical merger to monopoly would result in a 182 per cent increase in the number of patients experiencing harm. Our main estimate is that a hypothetical future merger between two geographically proximate hospitals would, on average and assuming no offsetting clinical benefits are unlocked by the merger, result in a 41 per cent increase in harm rates.

“If the harm rate were to increase by 41 per cent as a result of a representative merger affecting all specialities in the hospitals, across both trusts involved, this would give an additional annual cost of £2.5m per year counting only the four harm types.”

The CMA has experience in this role

The CMA has been active in this area before. They had a key role in reviewing NHS provider mergers with respect to the Health Act of 2012 and in 2013, they were significant in the blocking of a merger between Poole Hospital FT and the Royal Bournemouth and Christchurch Hospitals Foundation Trust and Poole Hospital FT.

At Atlantis Medical, we fully understand the pressure that hospital trusts are under and why there is such a pressing need for these organisations to make the most of what they have. In this regard, it is very easy to see why merging nearby trusts or similar trusts would appeal.
However, if the findings in the study are remotely true, there needs to be serious consideration placed into mergers. The health and safety of patients must be paramount at all times and this study would suggest that this isn’t the case. It is vital that the NHS works harder to reduce costs but it cannot be undertaken at the expense of people’s health and well-being.


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