STRUCTURE: The NHS competition watchdog has approved Central Manchester University Hospitals’ proposed takeover of Trafford Healthcare Trust, the hospital known as the “birthplace of the NHS”.

The Cooperation and Competition Panel last week reported that the merger – which would take the Central Manchester foundation trust’s market share to more than a fifth of the city’s admissions – was “unlikely to give rise to a material cost for patients and taxpayers”.

Trafford Healthcare – where the NHS was symbolically inaugurated by Aneurin Bevan, minister of health, in 1948 – selected Central Manchester as its preferred “acquisition partner” last July. This was after Trafford concluded it could not reach FT status alone by the government’s 2014 deadline.

The small district general hospital faced deep financial challenges. In 2010-11 it needed a £10m strategic health authority bailout to break even, and commissioners have proposed to cut its main acute contract from £75.5m to £39.5m over the next five years.

Alongside the merger process, commissioners are developing proposals for reconfiguration of some Trafford services, which are expected to go to public consultation in May.

The CCP report notes that in 2010 Greater Manchester primary care trusts removed Trafford’s inpatient maternity and paediatric services.

“Given this recent decision by local commissioners, and the proximity of alternative accident and emergency departments in Greater Manchester, it seems likely that future commissioners may reconsider the current accident and emergency provision at Trafford Hospital,” it states.

However, the CCP argued that if Trafford was to lose its remaining contracts for non-elective services, most of the business would go to nearby Salford Royal Foundation Trust, and not to Central Manchester’s existing services. The watchdog therefore concluded that a merger was unlikely to reduce the combined organisation’s incentives to compete to retain non-elective services on all its sites.

According to Central Manchester’s submission to the CCP, the merger would take the foundation trust’s share of admissions in Greater Manchester from 16.5 per cent to 21.8 per cent.

It stated that it was “expected” Trafford’s commissioners and Central Manchester would “pursue some reconfiguration” following the merger. “Many of the services currently provided by THT are comparatively small, and it is likely that for some of those it would be difficult to maintain a safe and effective clinical service across all current sites,” it added.