The Co-operation and Competition Panel has approved two hospital mergers, called another in for further scrutiny and opened a file on a fourth.

The advisory body to the Department of Health last week gave the green light to the takeovers of Scarborough and North East Yorkshire Healthcare Trust by York Teaching Hospital Foundation Trust, and Trafford Healthcare by Central Manchester Hospitals Foundation Trust.

The panel said elective services at Scarborough currently provided no competition for those in York and after the merger Scarborough patients would still have sufficient choice, with alternative services offered by South Tees Hospitals and Hull and East Yorkshire Trust.

Speaking to HSJ after the approval was announced, York chief executive Patrick Crowley said: “Scarborough has for a long time been regarded as a challenged organisation, largely to do with its geography, its ability to recruit key staff, its financing and its demography – all of which has affected its viability in clinical and financial terms. The system has wrestled with these problems for many years.”

He said the DH and North of England strategic health authority cluster had needed to agree a way forward. This agreement had now “been supported in spirit and substance”.

“There was also recognition that there were some legacy issues Scarborough would bring with it,” he added.

The agreement will see capital money used on upgrading part of the Scarborough site and a five-year continuation of an existing subsidy provided by the SHA cluster.

The panel also last week decided there was a “realistic prospect” of the proposed merger between North West London Hospitals Trust and Ealing Hospital Trust breaching competition rules. The panel will collect evidence and submit a full report on the proposal by 13 June.

The merger would create an organisation with a turnover of approximately £600m.

An investigation was also opened by the panel into the proposed takeover of Dartford and Gravesham Trust by Medway Foundation Trust.

The letter to the panel from Medway’s transition programme director Jeremy Moon said each organisation had agreed its “clinical and financial sustainability was increasingly difficult to maintain in the medium to long term”.

A recommendation on whether the move could impair competition is due by 2 August.