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NHS Confederation - Healthcare 'groups' can work better than formal mergers

Targeted alliances, time-limited partnerships and collaborative working can produce better joint working outcomes than formal organisational mergers, according to a new NHS Confederation report published yesterday.

With the combination of current system pressures possibly heralding a wave of organisations joining forces, Healthcare groups: an alternative to merger-mania? says that historically, the health service has a 'poor track record' of mergers successfully delivering their stated objectives.

It asks if the NHS would gain from more providers establishing 'healthcare groups' - formally agreeing to work jointly on an area of shared interest - rather than risking the pitfalls that can accompany formal mergers, which can include reduced staff morale and falls in productivity.

Joint working possibilities

Produced by the NHS Confederation's Hospitals Forum in collaboration with independent health consultancy Finnamore, and based on evidence from past and current partnerships in the health service, the briefing offers up a spectrum of joint working possibilities.

These range from 'mutual collaboration' in which two or more providers pool resources for a particular function or service, through to a 'federated model', involving partners delegating aspects of their management or leadership to a group organisation which they co-own.

The paper includes a unique model of collaboration options which Finnamore has produced from its own experience working with health providers. The matrix sets out the 'trade off' required for various models of joint working, plotting the potential organisational upheaval against the likely benefits of collaboration.

Buffet of options

NHS Confederation chief executive Mike Farrar said: “The approaches in this briefing will of course need tailoring to local health economies, but the point of this paper is to remind people that joint working involves a buffet of options, not a fixed menu."

"There are lots of factors to consider when looking at organisational mergers in the NHS, not least the continual crusade to reduce our spend on 'back office' functions so that more from every pound can go on direct patient care.

“It is absolutely right that we continue to look at all the options on the table, but we must also recognise that wholesale mergers of provider organisations are not the only way to deliver economies of scale, increase joined-up working, and ensure a shared commitment from multiple organisations."

Strengthen connections to local people

Mr Farrar added that: "The new options for governing through healthcare groups set out in this paper can strengthen rather than reduce the connections to local people, and help maintain safe local services. They could also mean less upheaval for staff and for patients, many of whom worry that they will lose a valued service or even their job.”

Find out more

Download the briefing.

Find out more about the Hospitals Forum and how it supports members


Georgie Agass

Francesca Reville


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