The Competition and Markets Authority (CMA) has been looking at the impact on the quality of healthcare services from the planned merger between Central Manchester University Hospitals NHS Foundation Trust (CMFT) and University Hospital of South Manchester NHS Foundation Trust (UHSM).
UHSM operates Wythenshawe Hospital and Withington Community Hospital, and CMFT operates Manchester Royal Infirmary, Manchester Royal Eye Hospital, Royal Manchester Children’s Hospital, Altrincham Hospital, Saint Mary’s Hospital, The University Dental Hospital and Trafford General Hospital.
In its provisional findings report today, the group of independent CMA panel members investigating the merger has found it could have some effect on competition and patient choice in the supply of elective services and some specialised services. The group will now look in detail at patient benefits the trusts claim will result from the merger to see if these outweigh any concerns.
The provisional findings report has found that significant financial pressures in the NHS along with local plans (in response to policies from commissioners and national regulators) which focus on greater collaboration and integration between healthcare providers, have dampened the role of competition between the trusts.
John Wotton, Chair of the Manchester hospitals merger inquiry group, said:
If we see convincing evidence of how this merger can benefit patients then we will look to clear it. We will now examine carefully the case put forward by the trusts before we come to a final decision on whether those benefits to patients will outweigh any loss of competition or choice.
Although the merger could reduce choice for patients and commissioners, we think the effects are likely to be limited. Recent developments both nationally – and in Manchester following devolution of health and social care – mean that in practice NHS providers are less able to act independently, which limits the extent to which they look to compete with each other.
In assessing the effect on patient choice, the CMA has been looking in detail at the elective (that is, non-emergency) procedures across a number of clinical specialties and maternity services provided by both trusts. It has also looked at certain specialised services commissioned by regional and national bodies, non-elective care and community services, all of which are also provided by the trusts.
The CMA has heard from local commissioners, the devolved health body in Manchester, NHS England and NHS Improvement, all of whom have expressed strong support for the merger. In particular, NHS Improvement has told the CMA that it will help deliver improvements for patients more quickly and at less cost than would be the case without the merger.
The provisional findings report has been published on the case page where all other information relating to this investigation is also available. The CMA must publish its final decision by 13 August 2017.
Patients and their representative groups, commissioning groups, other health providers, regulators, local authorities and any interested bodies are invited to give their views on the provisional findings (by 7 July 2017) and notice of possible remedies (by 29 June 2017), by email to cmft.uhsm.nhs@cma.gsi.gov.uk, or by post to:
Project Manager
CMFT/UHSM merger inquiry
Competition and Markets Authority
Victoria House
Southampton Row
LONDON
WC1B 4AD
Notes for editors
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The CMA is the UK’s primary competition and consumer authority. It is an independent non-ministerial government department with responsibility for carrying out investigations into mergers, markets and the regulated industries and enforcing competition and consumer law. For more information see the CMA’s homepage on GOV.UK.
- On 25 February 2015, the 37 NHS organisations and local authorities in Greater Manchester signed an agreement with the government to devolve health and social care expenditure in Greater Manchester. This followed the agreement between the Chancellor of the Exchequer and leaders of the Greater Manchester Combined Authority (GMCA) devolving new powers and responsibilities to Greater Manchester on 3 November 2014. As a result, the Greater Manchester Health and Social Care Partnership assumed control over the region’s health and social care budget, which amounts to approximately £6 billion per year.
- The test the group of CMA panel members is required to consider is whether the proposed merger may be expected to result in a substantial lessening of competition in relation to the services the hospital provide. They provisionally found that, in relation to certain elective (including maternity) and specialist services, it would.
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