Timeline: Bournemouth and Poole merger saga

November 2011: The boards of Royal Bournemouth and Christchurch Hospitals and Poole Hospital foundation trusts agree to pursue a merger in order to ensure the retention of “sustainable local services”. It is the first proposed merger between two FTs.

May 2012: The merger between the two foundation trusts is referred to the Office of Fair Trading to be scrutinised for its impact on competition, in line with clause 79 of the 2012 Health and Social Care Act.

January 2013: The OFT refers the merger to the Competition Commission for an in-depth review after concluding that it would leave local patients and commissioners with “few realistic alternative providers”.

February 2013: HSJ reports that Royal Bournemouth and Christchurch Hospitals and Poole Hospital could be prevented from freely communicating with each other while the Competition Commission reviews the merger case.

The commission asked the trusts to sign undertakings committing not to hold discussions without the presence of independent observers while the review takes place.

July 2013: In its provisional findings, the Competition Commission says a merger could lead to a substantial lessening of competition in 58 services, including maternity and accident and emergency.

Commission chair Roger Whitcomb said the group examining the merger had been unconvinced by the trusts’ argument that the actual level of competition between them was small. The commission also rejected the argument that without a merger Poole Hospital was likely to fail and exit the market.

Policy surrounding NHS service change is called a “mess” after the merger is ostensibly blocked on the same day that NHS England chief executive Sir David Nicholson demands radical service reconfiguration nationwide.

August 2013: The Competition Commission’s final decision is delayed till October.

Also in August, the FTs propose their performance in the friends and family test is used to mitigate against the loss of competition. Royal Bournemouth and Poole put forward the potential “remedy” to the Competition Commission that if the score against the friends and family patient experience test fell below level 2 for any of a given set of services, commissioners would retender them

September 2013: It emerges the trusts breached their undertakings not to communicate about their merger plans in July and, with the merger likely to be blocked, they have started work on alternative plans.

October 2013: Before the Competition Commission announces its final decision, Monitor chief executive David Bennett says at an HSJ roundtable the regulator is in talks with the Office of Fair Trading to try to prevent trusts that want to merge from facing drawn out inquiries under competition law.

On 17 October, the proposed merger of Royal Bournemouth and Christchurch Hospitals and Poole Hospital foundation trusts is blocked by the commission after it concludes there is insufficient evidence patients would benefit from the plans.