This month’s trust chief executive barometer presents a relatively rosy picture of the NHS provider market.

The representative sample has a good level of confidence that providers will be able to maintain the quality of its services, achieve forecast surpluses (or deficits) and both attract and retain the workforce required to make this happen.

However, scratch the surface and there are some rather more interesting results.

Providers appear to still be in a relatively expansionist mode, with only 25 per cent thinking that the range of their services will reduce over the next 12 months.

Does this result reflect the fact that vertical integration has insulated acute providers from the risk of services being driven into the community? Or, more cynically, can it be explained by reference to the low level of confidence in the capacity of commissioners to carry out their roles effectively?

Interestingly, significant numbers of providers are involved in or considering some sort of transaction to effect organisational change. Again, the mood is quite expansionist, with a third of respondents looking to acquire part of another organisation.

To date, the NHS mergers and acquisitions market has been dominated by whole-organisation mergers and acquisitions, often as a means of achieving FT status. This result suggests we may be moving into a new phase, where services are disaggregated.

Finally, it is reassuring that most providers are confident they will achieve their forecast year-end financial position.

It will be interesting to see whether that high level of confidence carries over to the next Barometer…

Acute sector faces wave of mergers and reconfigurations