There is a growing consensus that NHS trusts in general, and the acute sector in particular, are about to enter a new phase of organisational consolidation.
A combination of system pressures may mean a wave of mergers, as trusts look to increased scale as a means of weathering staffing pressures, declining tariff payments, long-term shifts in demand and, for some, the foundation trust pipeline.
Yet the track record for mergers and the “bigger is better” view is not good. Evidence suggests that objectives are rarely achieved or, if they are, are outweighed by the downsides of a larger, less agile entity.
Seeking an alternative, a number of acute providers have in recent years pursued more targeted alliances – often termed ‘groups’ – to get the benefits of collaboration without the upheaval or loss of autonomy
required by a merger.
With some of these arrangements now showing real promise, and leaders looking with interest to see what might be replicated, this briefing summarises key learning from those who have already had involvement in developing healthcare groups and considers what might be done to take the concept further.