Two Kent trusts will seek to expand their market share in surrounding health economies, including becoming the main acute provider for a London borough, if their merger bid is successful.

Medway Foundation Trust is currently in the process of attempting to acquire its neighbour Dartford and Gravesham Trust.

The two trusts announced their ambition to create a single organisation in September, in order to safeguard their future financial and clinical viability.

However, their outline business case also highlights the “opportunity to grow market share in neighbouring health economies”, including the “aim to be the local acute provider of care for the Bexley population”.

Dartford and Gravesham has already begun developing a secondary market for providing services to patients in Bexley due to changes over the past 18 months.

Since the closure last year of A&E and maternity services at Queen Mary’s Sidcup, which is run by the financially troubled South London Healthcare NHS Trust, Dartford and Gravesham has boosted its percentage of clinical income from south east London from 8 per cent in 2010-11 to 17 per cent in 2011-12.  

“The synergy of the north Kent and Bexley population gives the integrated organisation greater prominence to deliver services to meet local health care priorities,” the outline business case said.

It notes that the two populations are characterised by a “relatively younger age grouping and a significant prevalence of obesity”.

The business case also highlights several other specific examples of opportunities to increase market share in Bexley.

It states that the two trust’s dermatology and ear, nose and throat outreach clinics, which are already provided jointly, represent a “natural platform” to take on Bexley activity.

In addition, there are also “future plans” to develop a outpatient and inpatient renal services to the populations of both north Kent and Bexley. These are likely to include low clearance clinics, a renal anaemia service and acute kidney injury service.

Future commissioners for the capital have indicated to HSJ that they do not view the merger as negative.

Howard Stoate, chair of Bexley Clinical Commissioning Group, said: “Our priority is a strong stable trust that can deliver the best healthcare.  If a merger achieves that goal, then that’s something I support.”

A spokesman for South London Healthcare NHS Trust said: “It is good for patients that choice is as wide as possible.

“When exercising that choice, patients will be guided by the quality and safety of the services and we are pleased that the safety of services provided by South London Healthcare are now among the best in England, with mortality and infection rates lower than the national and local average.”

Meanwhile, the merger business case notes that last year Maidstone and Tunbridge Wells Trust removed maternity services and downsized A&E at its Maidstone site, which is the closest hospital to Medway FT.

Medway has therefore seen an increase in A&E attendances and births from the Maidstone area. It anticipates market share, and therefore income, in these clinical areas would increase further following a merger and associated increase in profile of the new organisation.

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