The proposed merger between two trusts in Surrey has hit a stumbling block after the Competition and Markets Authority said the merger could have ‘adverse effects’ for patients and it has launched an investigation.

Royal Surrey County Hospital Foundation Trust and Ashford and St Peter’s Hospitals Foundation Trust put forward their proposal to merge in May last year.

They hope to offer more specialist services and to establish a major emergency centre on one of the sites if the merger goes ahead.

Surrey shoppers

The CMA judged that the benefits of a merger of two trusts in Surrey did not outweigh concerns over competition loss

The CMA said the merger could restrict competition and choice for patients in elective specialties. Six inpatient and seven outpatient services could be affected, the authority concluded. These are high volume specialties that could affect “tens of thousands of patients each year”.

This is the second time the CMA has recommended a second phase investigation into merger proposals. The proposed merger between The Royal Bournemouth and Christchurch Hospitals and Poole Hospital foundation trusts was investigated. The plans were eventually blocked.

This investigation stage is expected to take six months to complete.

Monitor told the CMA the merger could allow seven day working in stroke, interventional radiology and gastroenterology services.

However, the CMA judged that these benefits did not outweigh its concerns over competition loss.

The trusts have five days to contest the CMA’s decision to investigate further.

Andrea Coscelli, executive director of markets and mergers at the CMA, said: “Our job is to look at the evidence and examine the impact that a proposed merger could have on patient choice and the quality of healthcare services provided.

“Tens of thousands of patients a year are treated by the trusts in the specialties we’ve looked at and could be potentially affected by the loss of choice they currently have. If the trusts no longer have to attract patients who might choose to go elsewhere, it could mean their incentive to maintain and improve quality in those specialties is reduced. 

“We acknowledge that there may be some benefits which result from the merger but given the extent of our concerns and the number of specialties and patients involved, we feel it is necessary to look at this merger in greater depth to ensure that it is in patients’ interests.” 

Royal Surrey chief executive Nick Moberly said: “We’re obviously disappointed with this decision as we believe a merger would result in a number of positive benefits for patients.

“Both boards will be discussing the CMA decision at their respective meetings next week to consider what implications the referral might have for us, and we will keep staff, patients and local residents up to date as soon as we have further news.”

Suzanne Rankin, chief executive at Ashford and St Peter’s Hospitals, said: “Although this was not the decision we were hoping for, we understand that the CMA needs to carry out a more in-depth analysis of our plans to ensure this is in the best interests of patients. Unfortunately this means we will need to wait longer until a final decision is reached.”

A Monitor spokesman said: “We note the CMA has decided to give the merger further consideration after finding potential adverse effects for patients through reduced choice and competition across a range of elective specialties. As the health sector regulator, Monitor advised the CMA on the patient benefits of the merger.

“If the merger goes ahead it could improve access to senior consultants in stroke, gastroenterology and interventional radiology services for a significant number of patients. Patients who come to hospital in the evenings or at the weekend would especially benefit from having better access to consultants seven days a week. There are also some improvements to patient care which we found could happen without a merger, including improvements to neonatal services and increased access in neurology and specialist diabetes services.

“Once the CMA makes a decision, we will work with the trusts to help them improve patient care whether the merger goes ahead or not.”