STRUCTURE: Two mental health trusts in the North West are in discussions over a potential merger.

  • Calderstones Partnership FT and Mersey Care Trust in talks about formal merger
  • NHS England advisor says “institutions such as Calderstones Hospital” should be closed
  • FT insists it has a future as many of its patients need to be cared for in secure settings

Calderstones Partnership Foundation Trust, based in East Lancashire, revealed its “long term strategy of formal merger” with Mersey Care Trust in recent board papers.

Calderstones, which expects to turn over £42m in 2015-16, provides specialist and secure services for people with learning disabilities. It was heavily criticised by the Care Quality Commission in December.

Calderstones Partnership Foundation Trust

Calderstones was heavily criticised by the CQC last year

In January, the author of an NHS England commissioned report on learning disability services, Sir Stephen Bubb, said “institutions such as Calderstones Hospital” should be closed and more patients treated in the community. A review of services in the north was launched in January and is ongoing.

Calderstones has insisted it still has a future, pointing out that many of its patients have committed serious crimes and still need to be cared for in secure settings.

Mersey Care, which forecasts a £206m turnover for this year, provides specialist inpatient services, including the high security Ashworth Hospital, as well as community mental health, learning disability and substance misuse services.

Mersey Care chief executive Joe Rafferty said the organisations had been in talks since last year about the joint provision of a new medium security unit in Maghull, when there was “lots of movement in learning disability policy around moving patients away from institutional settings”.

He told HSJ: “It’s not for me to talk about the closure of Calderstones, but if you extrapolate the policy intentions it certainly calls into question the sustainability of organisations like it.

“I don’t think there’s a requirement for secure services that people live in or have very long lengths of stay, in low or medium secure units.”

He said the merger discussions were in line with the NHS Five Year Forward View, as well as the Dalton review, which recommended the acquisition or franchising of trusts that cannot demonstrate long term viability in their current form.

The trusts hope to draft an outline business case by the end of the year.

Asked whether the deal represented a takeover of Calderstones, Mr Rafferty said: “It may have a headline of ‘takeover’, but for me it’s about merger and the operational and clinical strategies for caring better for patients.”

He said the two trusts have an opportunity to create a “centre of excellence” for medium secure services, and this would likely result in the centralisation of services and the closure of some units.

According to the Calderstones’ April board papers, the trust’s total bed base will reduce from an average of 215 to 182 this year, including losing 17 secure and 16 step-down beds, with a loss of NHS clinical income of about £4m.

Mr Rafferty said Calderstones is “very sensitive” to changes in its turnover, and closer working between the organisations could provide opportunities for staff to switch roles, or for redundancy costs to be absorbed.

Calderstones chief executive Mark Hindle said: “Later this year, both boards will examine an outline business case for closer cooperation. This means exploring opportunities for how higher quality care can be provided for people with learning disabilities in a secure setting.

“We are like minded organisations, we support a particular group of service users and reports such as the recent NHS staff survey show a similar staff profile in many areas – joining up our thinking and creating new synergies such as the new build in Maghull is the way forward for the NHS in general, and for our service users in particular.”