Mergers in the NHS
Mergers in the NHS

The following Competition guidance note provides comprehensive and up to date legal information covering:

  • Mergers in the NHS
  • Key points in relation to the CMA process when applied to FTs and NHS trusts
  • Mergers between NHS trusts
  • Substantive assessment of NHS mergers—the Poole/Bournemouth proposed merger
  • After Bournemouth/Poole

There are currently two types of NHS hospitals (ie public healthcare hospitals) in England: NHS Foundation Trusts (FTs) and NHS Trusts. In the event of a merger between NHS hospitals, depending on the nature of the merging hospitals, the applicable UK merger control regime and procedure may differ (although technically speaking the UK authorities' powers are said to be concurrent):

  1. mergers between private healthcare operators are reviewed by the Competition and Markets Authority (CMA) under the general UK merger control regime. Note—Private patient units (PPUs) of NHS hospitals are considered to be 'enterprises' for the purposes of merger control and are also reviewed under the general UK merger control regime

  2. mergers between a private healthcare operator and an NHS hospital (ie either an FT or an NHS Trust) are reviewed by the CMA under the general UK merger control regime, taking account of an opinion from NHS Improvement (previously Monitor) in respect of patient benefits as regards the NHS healthcare aspects of the merger

  3. mergers between FTs or between an FT and an NHS Trust are reviewed by the CMA under the general UK merger control regime, taking account of an opinion from NHS Improvement (previously Monitor) in respect of patient benefits, and

  4. mergers between NHS Trusts only are reviewed by NHS Improvement (previously Monitor) under a healthcare-specific merger control regime.

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