Three West Midlands hospital trusts are to create an alliance with a combined turnover of almost £1bn and a catchment population of more than 1 million, HSJ can reveal.

The Black Country Alliance is being created as a joint venture partnership to make efficiency savings and improve clinical sustainability in the region north of Birmingham.

The trusts involved are:

  • Sandwell and West Birmingham Hospitals Trust;
  • The Dudley Group Foundation Trust; and
  • Walsall Healthcare Trust.

Walsall chief executive Richard Kirby told HSJ the alliance was a way to ensure his trust’s long term viability: “It is pretty clear to us that the best way we can sustain and develop a number of our acute based services is in partnership.


The alliance is not a formal merger and each trust will retain its sovereignty

“This is the way to generate that critical mass that means the conversation about our services can be how they develop in the future, rather than how we struggle to survive.”

Although there will be an overall programme board to oversee its work, the alliance is not a formal merger and each trust will retain its sovereignty. The alliance intends to create a jointly owned company limited by guarantee before the end of 2015-16.

A document sent to the three trust boards, seen by HSJ said: “A company limited by guarantee creates a corporate body that will allow us to bid relatively easily for contracts in time, and hold funds in common, both of which may be essential enablers to the solutions for areas in scope for the Black Country Alliance.”

Only work agreed by all three members will be taken forward and the trusts will continue to work with existing partners on integration and new care models.

The Royal Wolverhampton Hospitals Trust has opted not to join the alliance at this stage but it will not be exclusive and could extend its membership in future.

The three member trusts, which each provide community services, have told HSJ they will continue to have separate A&E and maternity departments up to 2020.

In its first year the alliance will look at changes to back office functions including:

  • combining HR, payroll and other administrative services;
  • a strategic review of procurement processes;
  • a review of estates including the management of private finance initiatives; and
  • improving IT.

In clinical areas the alliance will look to increase the scale of activity to boost recruitment and enable greater collaboration such as shared rotas and joint appointments. This will initially focus on improvements in:

  • interventional radiology;
  • histopathology;
  • urology; and
  • rheumatology.

Dudley Group chief executive Paula Clark said her trust was sustainable for the next three years but the changing models in the NHS meant the trust needed to look at a different way of providing services.

She added: “What we are very aware of is if we started talking about ‘merger’ it is a massive distraction and you could lose a lot of energy from people who are very keen and open to collaboration. With the joint venture vehicle we have set up, we have an opportunity to do something quite different and people don’t feel threatened by that.”

Sandwell and West Birmingham chief executive Toby Lewis said: “What we have got here is three organisations that have a lot in common. There is a level of subspecialist care that has always been provided by large district general hospitals and as medicine becomes more and more subspecialist there comes a discussion around where that boundary should lie. We are looking to support really high quality subspecialty care… by working together.”

The alliance will also allow the three trusts to explore larger research and development projects that would not be possible individually.