The must read stories and debate in the NHS from Thursday

Money makes the world go round

Trust mergers are as popular with the Treasury and Department of Health as ever, as our Following the Money expert briefing explores this week.

But they don’t come cheap.

In the last few days, two examples – mergers to create the two biggest providers in the NHS no less – highlight just how important the money is to get a merger over the line and make it a success.

In the North West, Manchester University Foundation Trust (the biggest trust in England, formed last year by combining Central Manchester University Hospitals FT and University Hospital of South Manchester FT) is likely to be given £125m in loans from the DH for a new electronic patient record, A&E reconfigurations, backlog maintenance and liquidity support.

Given how tricky it’s been for trusts to access capital from the centre in recent years, the money would be a huge vote of confidence for the merger and trust’s management.

But down the motorway, the merger of Heart of England FT and University Hospitals Birmingham FT has been delayed because the trusts are still waiting for assurances from NHS Improvement “regarding money, future liabilities and recompense for the cost of the transaction”.

The merger was approved by the Competition and Markets Authority last August and received enthusiastic support from NHSI, but HSJ understands the date for approving the merger has been pushed back several times since the summer.

The HEFT board was planning to approve a business case for the merger this week but it postponed a vote because while “progress had been made… not all assurances had been received”.

Previous transactions have benefited from significant DH support – Frimley Health FT was given access to £328m for its takeover of Heatherwood and Wexham Park Hospitals.