NHS Mergers – The Benefits & Drawbacks

I am looking to explore the benefits and drawbacks of NHS mergers from the perspective of the NHS, service users and employees of the organisation. Having met senior stakeholders within a number of NHS Trusts across the country it is clear that there are differing opinions, however the issue is becoming more prevalent as the public purse strings continue to tighten.

All mergers propositions have to consult with NHS Improvement who will advise on competition laws and will weigh up the benefits of the merger. It is likely that the Competition and Markets Authority (CMA) will review the merger and look at the benefits for service users and other matters that they deem appropriate. Pressure on CCG’s to merge has grown since the NHS’ long-term plan, published in January, revealed that integrated care systems (ICSs) would be rolled out across England by 2021, 'growing out of the current network of sustainability and transformation partnerships (STPs).

Service users

The CMA’s most recent study shows that merging hospital trusts could increase mortality rates by 550% and cause patient harm to almost triple. With less competition, questions have been raised about the quality of services being provided, and with an ever-growing population, will this pose even more problems in the future? 

The NHS

The NHS has to prioritise sustainability as part of its key development over the next 10 years so from a business perspective, it is clear that efficiency savings are necessary to ensure the long-term existence of publicly funded services. In order to achieve this, trusts are merging frequently in order to procure collectively, and therefore achieving better value for money. However, this also potentially reduces the number of non-clinical non-medical positions available. One final benefit for the NHS that I can see is that it will be easier for services to be benchmarked and quality to be controlled simply because policy and standards will become more centralised. 

Employees

Studies have shown that mergers generally have a small positive impact on staff job satisfaction in the immediate year prior to, and post-merger. Continuous support and management being under the spotlight is arguably some of the reasons that morale is improved. However, with mergers, a number of administrative posts otherwise known as non-medical non clinical within the NHS could be at risk due to the office functions combining, and therefore putting people at risk of redundancy. 

Conclusion

Whilst there are clear benefits to quality control, the public purse and procurement strategy, I am still not convinced that this counters the perceived risk to patient safety which is one of the core foundations of the NHS. The UK has been blessed with arguably the best healthcare service in the world for the past 71 years and in my opinion, it is important that strategic decisions to not dilute the effectiveness of the organisation. I would be very interested to get others thoughts on this and I look forward to reading your responses in the comments section. 

If you have any questions regarding the above, or would like to discuss this further, please get in touch at [email protected].