CMA provisionally clears foundation trust hospitals merger

Ashford and St Peter’s Hospitals NHS Foundation Trust (ASP) and Royal Surrey County Hospital NHS Foundation Trust (RSC) provide clinical services from their sites in Ashford, Chertsey and Guildford.

The proposed merger was referred for an in-depth phase 2 inquiry in February after an initial Competition and Markets Authority (CMA) investigation found that the proposed acquisition might result in a substantial lessening of competition across a range of healthcare services.

Competition in the NHS is one of a number of important drivers of the quality of services for patients, supplementing the role played by regulation, various regulatory bodies and commissioners as well as the professionalism of NHS staff. Patients have the right to choose which hospital to attend for a first consultant-led outpatient appointment. This patient choice creates an incentive for NHS providers to improve the quality of their services in order to attract patients and funding.

The CMA inquiry group investigated the potential impact of the proposed acquisition on the services provided by both trusts. These are elective services, emergency services, services provided to private patients, specialised services and community health services.

The group examined evidence from ASP and RSC about the provision of healthcare services in their area, as well as evidence from a number of third parties including patients and GPs in the area, Monitor, NHS England, local Clinical Commissioning Groups and neighbouring hospitals.

Based on the evidence provided, the inquiry group has provisionally concluded that the proposed merger, if completed, will not give rise to a substantial lessening of competition.

Simon Polito, Chairman of the inquiry group, said:

Choice of hospital for patients and commissioners has an important role to play in the NHS, as do a number of other factors that help to maintain and improve the quality of services. Indeed, we have been struck throughout this investigation by the commitment and professional pride in the provision of high quality care for patients shown by the many different NHS representatives we have encountered.

We have looked closely at ways in which the proposed merger might affect patient choice and the quality of healthcare services provided by the 2 trusts and other hospitals in their area.

The impact of a hospital merger on competition will largely depend on the number and strength of alternative service providers in the local area. There are a number of hospitals nearby which currently attract significant numbers of patients from the local area. We consider that these are viewed as credible alternatives by patients and GPs.

Against this background, and following a detailed investigation, we are satisfied that in each of the services where the hospitals overlap, the merged trust will face significant competitive pressures from other local hospitals.

We have therefore provisionally concluded that the merger is not likely to lead to a substantial lessening of competition that would reduce the range or quality of healthcare services provided to patients and we are proposing to allow it to proceed.

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