Leading 'ACS' to ask competition regulator to overturn restrictions

A business case is being drawn up which will outline the “patient benefits” if undertakings between Royal Bournemouth and Christchurch Hospitals and Poole Hospital foundation trusts are lifted by the Competition and Markets Authority, opening the door to a potential second attempt at a merger.

The FTs form part of the Dorset sustainability and transformation partnership, which is one nine health economies working with NHS England on becoming an “accountable care system”.

In 2013 the CMA blocked a merger between the trusts, ruling it would have led to a substantial lessening of competition, which would not have been outweighed by other benefits. In September the two trusts reopened merger talks because they believe planned changes to acute services in east Dorset “could be achieved more easily under one management structure”. However, undertakings signed in December 2013 mean they cannot attempt to merge for ten years, unless the CMA gives written consent.

Board minutes from earlier this year say that a new programme board will develop both a case for capital for planned service changes, “and the business case for the [CMA] to vary or remove the undertakings to allow continuation of the [planned service changes]”.

The minutes note that “to secure the variation or removal of the undertakings by the CMA”, it would first need to get NHS England’s commitment to provide the required capital for its planned services changes. It is not expected to happen until later this year.

The work will be led by a new programme director, Stephen Killen, who is also programme director of the ’Developing One NHS in Dorset’ acute care collaboration vanguard. 

The new programme board includes executive and non-executive directors from Dorset’s three acute trusts: 

• Royal Bournemouth and Christchurch Hospitals Foundation Trust;
• Poole Hospital Foundation Trust; and
• Dorset County Hospital Foundation Trust.

The trusts are awaiting a final decision from Dorset Clinical Commissioning Group on exactly how the acute services will change.

The preferred option (costing an estimated £147m) is to centralise emergency services at the Royal Bournemouth and Christchurch Hospitals FT and make Poole Hospital FT a major planned care centre with an urgent care centre.

There would also be changes to community care, with “community hubs” being developed and the potential closure of a small number of community hospitals.

A public consultation, which received more than 18,000 responses, closed at the end of February and the results will be published in September – followed by the CCG’s final decision.

No formal approach will be made to the CMA regarding a potential merger until after this decision, a spokesman for the Royal Bournemouth and Christchurch Hospitals FT told HSJ.

Meanwhile a bid has been submitted on behalf of the Dorset NHS at the end of April to NHS England for a share of the £325m pot for areas with advanced sustainability and transformation plans, according to board papers from Royal Bournemouth and Christchurch Hospitals FT.

The trust did not say how much money is sought, but a decision is expected in June.

Its board papers say if the bid is successful the money will “underpin the detailed design of the planned and emergency sites, and aid the transfer of some services into the community”.

This will free up capacity to “create the infrastructure necessary to accommodate the reorganisation of services”, according to a report by chief executive Tony Spotswood.

Consultants from McKinsey and Company are helping local chiefs to develop the case for more capital investment for both the planned and emergency site.