STRUCTURE: The decision on whether the first merger between two foundation trusts can go ahead has been delayed until October to give the Competition Commission more time to consider the potential patient benefits.
The commission was originally due to make its final ruling on the merger of Royal Bournemouth and Christchurch Hospitals and Poole Hospital by next Tuesday.
However, it has made use of a power allowing it to extend the period of consideration by eight weeks. A decision is now due by 21 October.
In a notice announcing the extension, commission chair Roger Whitcomb said the group investigating the merger had extended the deadline to allow it “sufficient time” to consider the trusts’ revised arguments about the merger’s benefits.
The trusts had previously argued that without the merger Poole would be financially unsustainable and ultimately be taken over by Royal Bournemouth anyway. The commission rejected this reasoning in its provisional findings, concluding Poole was an efficient and well run organisation.
The trusts’ revised arguments, published by the commission today, focus on the clinical benefits of the proposed service changes, including increased senior consultant cover in accident and emergency.
Noting they do not accept the commission’s provisional findings about the level of competition between the two organisations, the document says the trusts will nevertheless seek to demonstrate how the merger’s benefits would outweigh the perceived loss of competition.
“For the commission to block the merger it would have to believe that the substantial lessening of competition (SLC) arising from the merger will lead to an unprecedented loss of quality in the relevant services [in order] to conclude that these benefits are insufficient to offset the SLC,” the document states.
“The Parties do not consider such a finding plausible.”
Some benefits, such as rebuilding Poole’s leaking maternity unit, or taking its cardiologists out of the trust’s general acute rota to focus on specialist work, could be instigated as soon as the merger was complete.
However, all other proposed changes would be subject to public consultation. HSJ understands there is concern that the trusts could be at risk of future judicial review if they appear to have prejudged any public engagement. As a result, the eight page document stresses 23 times that any proposed changes would be subject to consultation. It also states the trusts do not have a preferred site for A&E and emergency surgery.
It argues that reconfiguration of maternity services would increase choice for mothers, as consolidation of the midwifery rota would mean more women were able to choose home births. It adds that without the merger haematology services would leave Dorset, as it would not be viable for either trust to provide them independently.