London merger plans revealed

The plans, submitted to NHS London before the 1 April deadline set by the operating framework, reveal the first regional picture of the transforming community services programme and appear to bear out predictions that most PCTs would opt for vertical integration.

12 PCT boards have chosen to vertically integrate their community services with NHS acute provider trusts or foundation trusts

HSJ’s research shows 12 PCT boards have chosen to vertically integrate their community services with NHS acute provider trusts or foundation trusts.

Seven have opted to vertically integrate with mental health trusts or mental health foundation trusts. Included with these is NHS Bexley, which intends to split its provider arm into two, giving adult services to a mental health foundation trust and children’s services to an acute trust.

The remaining group includes four PCTs aspiring to become a community foundation trust under the name Central London Community Healthcare, two social enterprises and one permitted by the Department of Health to remain as a direct provider.

Four PCTs - Greenwich, Camden, Hounslow and Richmond - are still to submit their proposals.

The cooperation and competition panel this week published details of a fast track review system for mergers, developed in part as a response to the tight transforming community services timescales.

The guidance suggests mergers between two provider arms are likely to be eligible for fast tracking as they are likely to be consistent with the Principles and Rules for Cooperation and Competition.

But those involving vertical integration may not be eligible because of the “potential to reduce competition and choice through affecting referral volumes”.

Such cases will require further investigation to ensure safeguards are in place to deal with any concerns.