Hospital mergers ‘not effective’ way to deal with NHS problems

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Hospital mergers do not bring benefits for patients and are unlikely to be the most effective way of dealing with financial problems, according to a Government-funded report.

Experts said merging hospitals leads to a decline in financial performance, productivity does not change, waiting times for patients rise and there is no indication of an increase in clinical quality.

The study, funded by the policy research programme at the Department of Health, comes as some hospitals in England prepare to merge due to financial difficulty.

The Government has said it expects the majority of NHS trusts to become foundation trusts by April 2014, either on their own or through merger.

Some 20 trusts have already said they are not viable in their current form and of all those trusts in England yet to achieve foundation trust status, 80 per cent face financial issues.

In December, a report from MPs said the goal for the majority of NHS trusts to become foundation trusts by 2014 “will be extremely difficult to achieve”.

They warned that any mergers or reconfiguration of services must not lead to cuts for vulnerable people.

In the study, Professor Carol Propper and colleagues, from the centre for market and public organisation (CMPO) at the University of Bristol, examined mergers between acute hospitals in the six years after 1997.

Of around 223 acute hospitals in 1997, 112 merged sometime between 1997 and 2006.

The team looked at performance from two years before to four years after the merger date. The experts concluded: “We find that a merger results in a fall in the scale of a hospital in terms of total activity and total staffing. But that other than this removal of capacity, we find little evidence that performance improves due to merger.”

They also said removing capacity in hospitals may reduce patient welfare. “We show that waiting times rose post merger; travel distances may also rise when hospitals are closed.”

The study found that hospital admissions fell by around 10 per cent four years after hospitals merged, but the number of staff fell by about the same amount.

So per staff member employed, there was no increase in activity. Poor financial performance continued, so hospitals that merged made larger deficits post-merger than pre-merger.