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Merger off (for now)

The ambitious merger of three providers in the Midlands – which would have created one of the biggest community and mental health trusts in England – has been put on ice by NHS Improvement.

The merger of Birmingham Community Healthcare Foundation Trust, Black Country Partnership FT and Dudley and Walsall Mental Health Partnership Trust was meant to be completed by 1 December (after being pushed back from an original deadline in October) but has been paused indefinitely.

It is not clear why the merger plans have now been put on hold and a Birmingham Community spokesman said no new date had been confirmed for finishing the merger.

In a BBC report last month, Karen Dowman, former chief executive of Black Country Partnership, raised concerns about the proposed merger.

Meanwhile, three CCGs in the region have started their moves towards a merger, though not until 2019 at the earliest.

South Worcestershire, Wyre Forest, and Redditch and Bromsgrove CCGs will take a proposal to GP members later this month to have the CCGs “meet in common”, effectively as a single board, by April.

The CGGs appointed a joint executive team earlier this year, run all major committees jointly and share financial risk.

Accountable officer Simon Trickett, told HSJ the proposed arrangement was effectively akin to a merger, but any formal transition to a single organisation would be considered separately next year.

Merger on

The tentative merger between Liverpool’s two acute providers has begun to get serious.

Two years after deciding they are better off together, the boards of Aintree University Hospitals Foundation Trust and Royal Liverpool and Broadgreen Trust have now approved an outline business case.

Regulators are due to visit the trusts this week to review the plans, after which there will need to be a submission to the Competition and Markets Authority and a full business case approved.

If the financial estimates used to support plans are correct, the trusts could really do with moving things up a gear.

According to a recent loan application from Aintree, a report commissioning from McKinsey in 2014 reckoned that a merger and clinical reconfiguration between the trusts would release annual savings of 12-14 per cent on their combined costs of almost £900m.

Trusts with experience of mergers, or researchers who have studied them, would probably suggest savings of that order are a tad hopeful, but even a fraction of that would come in very handy.

Royal Liverpool was a long way short of its control total last year and looks set finish 2017-18 with a deficit of £14m – £10m behind plan.

Aintree posted a surplus in 2016-17, but the position is deteriorating and the trust has run out of cash to fund its £15m capital programme. A recent loan request to the Department of Health (quoting the McKinsey savings) was rejected earlier this year and it’s having to think about alternative options.