Mergers 'suck up'managers' time

Mergers and major service reconfigurations are distracting managers' attention from clinical quality, the Commission for Health Improvement has warned.

The message is set to be borne out by research commissioned by London region office on the impact of trust mergers, which HSJ understands will highlight the issue of 'unintended consequences' and urge a closer look at 'how to reduce the negative effects of mergers'.

The experience of zero-rated trusts, such as Barnet and Chase Farm Hospitals and Epsom and St Helier - both formed from controversial mergers - has also focused renewed attention on major trust reconfigurations.

CHI communications director Matt Tee said mergers 'suck up a lot of management time, and That is not just manager-managers but clinical managers as well'.

'Our experience is that where there has been a merger or a major service reconfiguration, because they are dedicating so much time to it, it is quite common that they take their eye off the ball of clinical quality.' He added that there appeared to be two models for mergers: one 'where you merge the management but not the services', and a second where procedures and processes were harmonised across the new organisation.

'Our view is that if you want to be successful, you need to do it - getting the same procedures and protocols in place in both parts of the organisation.'

NHS Confederation policy director Nigel Edwards said: 'A number of these hospitals had mergers because they had been deeply dysfunctional for a long time. This was an error - there was no reason why it should improve things.' And he claims it diverted management time from other areas of work. 'There is research from the commercial sector and the NHS that shows you lose 18 months to two years.'

'If you look at the zero and onestar trusts, We are starting to see a pattern where they had large mergers that were designed to deal with their problems. It is time to ask, are mergers giving us what we want? They do seem to be associated with a lot of problems and collateral damage.'

Tim Matthews, who as former chief executive of St Thomas' Hospital trust steered through its merger with Guy's in 1993, said:

'Mergers are hugely consuming of senior management resource and energy. There is a heightened risk that the eye gets taken off the ball of services delivery.'Mergers were 'no excuse for anyone falling short on standards of care', he said. 'But there is an issue of how well we learn from previous mergers.'