STRUCTURE: Two successful foundation trusts are exploring means of working together more closely, including a possible merger, in an attempt to meet the challenge of providing care in a rural setting.

The £350m turnover Royal Devon and Exeter FT and the £244m turnover Taunton and Somerset FT already collaborate on a number of clinical networks and share some consultants’ rotas.

A notice sent to staff last week said the two trusts would bring in a third party to look at “other opportunities to work in partnership”. 

It said the study would “seek to identify the benefits to patients that this might achieve in terms of both quality of care and economic efficiency”. 

HSJ understands a range of options will be considered – from sharing back office functions to a full merger. Both boards are said to have an open mind. Their work is being driven by a belief that the centralisation of services found in urban environments is not an option.

Both trusts have a Monitor financial risk rating of three, where five is the best, and Taunton has a green governance rating. Royal Devon and Exeter is rated amber-red for governance, although this is largely due to it exceeding the clostridium difficile limit, something the trust maintains is due to the introduction of more sensitive testing.

Royal Devon and Exeter chair James Brent said: “At a time of austerity, it is essential that NHS organisations - particularly those that exist within an hour’s drive of each other - work ever closer together to continue to achieve sustainable services of the highest quality.”

Taunton recently set up a joint venture with Yeovil District Hospital Foundation Trust to provide pathology services on a hub and spoke system from a new stand-alone laboratory.

The trust is also working with Weston Area Health Trust, which has admitted it is unviable in its current form, to explore new models for emergency care. It also has a vascular network with Northern Devon Healthcare Trust, an integrated acute and community services provider which has recently had its foundation trust application put back.

Taunton chair Ros Wyke said: “Although there has been significant progress in the South West of working in collaboration on clinical issues, neighbouring hospital trusts have not spent as much time in the past on working out whether there was mutual benefit in working in partnership.”

The study is due to be completed by the end of February 2013.