Competition & Markets Authority
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CMA clears Surrey hospitals merger

The CMA has formally cleared the proposed merger between 2 hospital trusts, following an in-depth investigation.

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 recent decision confirms the provisional findings that were published last month.

The proposed merger was referred for an in-depth phase 2 inquiry in February in order for the Competition and Markets Authority (CMA) inquiry group to examine the effects of the merger on patient choice and the quality of healthcare services provided by the 2 trusts and other hospitals in their area.

After looking at the effect on those services provided by both trusts (elective services, emergency services, services provided to private patients, specialised services and community health services), the inquiry group has confirmed that there will still be sufficient competition and choice for patients in the area after the merger.

The presence of a number of nearby hospitals, which attract significant numbers of patients from the local area and are viewed as a credible alternative by both patients and GPs, led the inquiry group to conclude that patients’ interests, in terms of continuing competition and choice, will not be harmed by the merger.

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.

The final report and all other information on the investigation can be found on the case page.

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.
  2. The CMA notified Monitor when it decided to carry out an investigation under the UK merger control rules, under section 79 of the Health and Social Care Act 2012, which applies to mergers involving NHS foundation trusts. Monitor provided advice on the effect of the merger under investigation.
  3. 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.
  4. Under the Enterprise Act 2002 a relevant merger situation is or will be created if 2 or more enterprises have ceased or will cease to be distinct enterprises; and the value of the turnover in the United Kingdom of the enterprise being taken over exceeds £70 million; or as a result of the transaction, in relation to the supply of goods or services of any description, a 25% share of supply in the United Kingdom (or a substantial part of it) is created or enhanced.
  5. Since the Health and Social Care Act in 2012, 5 hospital trust mergers have been cleared at phase 1, and one prohibited and one cleared at phase 2.
  6. Elective acute services are services that are planned and typically require a referral from a GP or an allied healthcare professional. Non-elective acute services (or emergency services) are services that are unplanned or provided in urgent circumstances, such as A&E, as well as supporting services such as emergency surgery and critical care. Services to private patients are services provided to private (fee-paying) patients. Specialised services are often low-volume, and tend to have few providers in a region. These services can be elective or non-elective. Community services are services provided in residential and community settings, such as schools and small local hospitals.
  7. Enquiries should be directed to Simon Belgard (, 020 3738 6472) or Rory Taylor (, 020 3738 6798).
  8. For more information on the CMA, see our homepage, or follow us on Twitter @CMAgovuk, Flickr and LinkedIn. Sign up to our email alerts to receive updates on merger cases.


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