Changing organisations: a study of the context and processes of mergers of health care providers in England

Helsefeltets strateger

“…v This section presents major findings reported by this review in combination with other key studies of mergers in health care (e.g. Fulop et al, 2002Fulop et al, , 2005.…”

“…This was soon followed by a merger wave in the UK of their National Health Service trusts (NHS). Between 1997 and 2001, 99 mergers of NHS hospitals took place (Fulop et al, 2002(Fulop et al, , 2005 and by the turn of the century "merger mania" had taken a strong hold within the UK (Cereste et al, 2003).…”

“…For example, Bazzoli et al (2004) find that stated merger motives are: improving organizational efficiency, financial performance, long-term survival, community accountability, and patient outcomes. Fulop et al (2002Fulop et al ( , 2005 mention economic gains, reduction of excess capacity to treat patients and increased effectiveness in certain clinical specialties (as the amount of activity increases) as typical merger arguments. Both Bogue et al's (1995) study of hospital mergers in the 1980s and Bazzoli et al's (2004) study of hospital mergers in the 1990s find that the three primary anticipated merger benefits were: (1) to strengthen financial performance, (2) to consolidate services and (3) to achieve operating efficiencies.…”

“…Wicks et al, (1998) conducted case studies of hospital mergers and conclude that operational efficiencies could be generated through consolidating key administrative functions, eliminating service duplication, closure or conversion of underused inpatient capacity, and exploiting economics of scale. Other researchers have focused not only on the potential monetary costs of implementing change, but also on the toll on organizations as they respond to challenges and potential resistance, which show a post-merger decline in efficiency (Dranove et al, 1996;Fulop et al, 2002Fulop et al, , 2005McClenahan, 1999). Taken together, the efficiency outcome after hospital mergers is rather mixed.…”

Liberating the NHS or trapping doctors?: The effects of NHS reform on today and tomorrow

“…The untested reform, expected to cost an estimated £1.7 billion, 14 will place strain on an already burdened NHS, at a time when the economy desperately needs stability and austerity. Given that the NHS is comprised of over 1.4 million employees, such significant changes will almost certainly detract from efficiency, 4 stunt cohesion and focus, and undermine improvements achieved over the past decade [15][16][17] all in the hope of saving £20 billion after full implementation. 2 Yet, the national reform may be able to foster a healthy relationship between primary and referred healthcare systems by inviting hospital doctors onto panels in charge of redesigning the primary healthcare service 18 which is undoubtedly one of Britain's proudest accomplishments.…”