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Update on merger proposals

The Boards of Aintree University Hospital NHS Foundation Trust and the Royal Liverpool and Broadgreen University Hospitals NHS Trust have both approved the Outline Business Case for a merger. These discussions took place at their separate Board meetings in October 2017.

The Outline Business Case was submitted to NHS Improvement for review. The briefing, circulated week commencing 4 December 2017, summarised the NHS Improvement response and timeframes involved.

This briefing highlights the benefits which a merger would offer and the next steps.

Why merge?

People living in Liverpool today have some of the highest levels of poor health outcomes and face some of the greatest health inequalities in the UK.

Modern healthcare, with increased specialisation, means that patients are more likely to require treatment from a range of specialist teams, working together.

The current arrangement in Liverpool, with the two major acute hospitals working separately, does not provide a full multi-professional approach to help patients. This is because the services are not joined up. Outcomes will be improved for patients by bringing staff together as single services, with city-wide delivery. This is the reason for the merger.

This proposal has been clinically-led. Merger is supported by senior doctors at both hospitals, and their Boards, as the most effective way of developing single services, and of benefitting patients. In addition, merger is supported by the area’s Clinical Commissioning Groups, the University of Liverpool and Liverpool City Council.

Benefits from merger

Having considered existing NHS plans in Liverpool and the experience of hospitals across the UK, there are many benefits from merger. These include:

  • Improved outcomes for patients through joined-up and patient-centred healthcare, centralised where necessary, local where possible.
  • Better access for patients, with the aim of consistently delivering the four-hour A&E standard, the 18 Week GP referral-to-treatment standard for planned procedures and the national cancer care standards.

  • Attracting and retaining the best healthcare staff, who want to work in what will be one of the country’s largest Trusts, reducing the current reliance on agency staff.

  • Significantly increased research funding, improving patients’ access to clinical trials and being a key part of the Knowledge Quarter, bringing investment and jobs to the city.

  • Maximising the benefits of digital technology, innovation and making best use of the NHS estate in the city.

  • Improved productivity and more cost-effective healthcare, creating both clinically and financially-sustainable services at a time when there are great pressures on NHS nationally.

Which teams would become single service first?

There are currently more than 20 clinical services duplicated at the hospitals. At this stage, the earliest the merger could take place is 1 April 2019. The only service planned to become single service before merger is orthopaedics. Analysis of the responses to the public consultation for this is currently being undertaken. All service changes will have appropriate consultation and engagement with patients, the public and staff.

The first year of the merged organisation would see single-service developments for:

  • Ear, Nose and Throat

  • Urology

  • Clinical Haematology, and

  • Nephrology (kidney care)

    The second to fifth year of the merged organisation would see single-service developments for:

  • General Surgery

  • Stroke

  • Dermatology, and other services.

These services are included in the part of the Outline Business Case which considers benefits to patients.

Next steps

The Trusts intend to work with NHSI on the next steps. In due course, a Patient Benefit Case will be submitted to the Competition and Markets Authority, the Government agency which reviews mergers which could potentially restrict competition. Work will continue to develop the Full Business Case, which will be much more detailed than the Outline Business Case. The staff and public engagement programme will continue, with staff involvement including medical, nursing, Allied Health Professional and support staff, now that the Outline Business Case has been approved by the two Trust boards. As part of this, the two Trusts will produce regular, joint briefings for all staff and stakeholders.

Formal consultation on any proposed service change will take place as required, as will employment consultation with staff. However, the timeframe for this depends on the two Trusts, together with NHS Improvement and the Competition and Markets Authority processes.

The NHS has put in place measures to ensure the safety of all patients and NHS staff while also ensuring services are available to the public as normal. If you have a hospital appointment then you should attend as planned.