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:

Notes for editors

1. 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.

2. 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.
3. 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.
4. For CMA updates, follow us on Facebook, Twitter @CMAgovuk, Youtube and LinkedIn.
5. Enquiries should be directed to press@cma.gsi.gov.uk or 020 3738 6798.

The current series of BBC Springwatch features two special items about flora and fauna which were filmed recently at the Defence Science and Technology Laboratory’s (Dstl) Porton Down site.

Porton Down will be featured in tonight’s episode, due to be broadcast this evening at 7:30pm on BBC Two. It will look at some of the animals that make their home amongst the chalk grasslands of Porton Down’s ranges.

A previous episode, which aired on Thursday 8 June, featured the flora that flourishes on the site, including the rare Lady Orchid. It is now available to watch on BBC iPlayer

Porton Down is one of, if not the, best-preserved chalk grasslands in Europe. The low level of human impact and development has enabled the man-made, semi-natural grassland to flourish and encourage a wide range of biodiversity. As a result, Porton Down boasts many rare species such as the Lady Orchid, the Duke of Burgundy butterfly and the Stone Curlew.

The programmes look at the many ways in which the wildlife flourishes and discuss the reasons for such an abundance of biodiversity. They also explore the relationships between the plants and animals, specifically insects and other invertebrates, as well as describing some of the various plant species that thrive on the plain.

In December last year, the Competition and Markets Authority (CMA) imposed a record £84.2 million fine on the pharmaceutical manufacturer Pfizer and a £5.2 million fine on Flynn Pharma after finding that each broke competition law by charging excessive and unfair prices for phenytoin sodium capsules, an anti-epilepsy drug. The CMA also issued directions ordering both companies to reduce their prices, which they have now done.

The decision sets out the evidence gathered by the CMA during its investigation and its reasons for finding that Pfizer and Flynn Pharma infringed competition law.

The decision and fines related to both the prices that Pfizer charged to Flynn Pharma for phenytoin sodium capsules and the prices that Flynn Pharma subsequently charged its customers for the product since September 2012. The CMA found that both companies held a dominant position in their respective markets for the manufacture and supply of phenytoin sodium capsules and each had abused that dominant position by charging excessive and unfair prices.

As a result of Pfizer’s and Flynn Pharma’s price increases, NHS expenditure on phenytoin sodium capsules increased from about £2 million a year in 2012 to about £50 million in 2013. Phenytoin sodium capsules are used in the treatment of epilepsy to prevent and control seizures, and are an important drug for an estimated 48,000 patients in the UK.

The full non-confidential decision and all other information on this investigation are available on the case page.

Pfizer and Flynn Pharma have lodged appeals against the decision with the Competition Appeal Tribunal. The hearing will start on 30 October 2017.

A reminder to submit your annual return for 2016, and information about the 2017 annual return service.