The Process and Impact of Trust Mergers in the National Health Service: A Financial Perspective

Hutchings, Andrew; Allen, Pauline; Fulop, Naomi; King, Annette; Protopsaltis, Gerasimos; Normand, Charles

doi:10.1080/09540962.2003.10874831

Cited by 6 publications

(5 citation statements)

References 5 publications

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“…This possibly would have given the post-merger hospitals more power. It is possible that this could have been offset by countervailing power from the smaller number of buyers in more rural areas, though as buyers tend to be the weaker group in the NHS (Hutchings et al, 2003), this countervailing power may be relatively weak.…”

Section: Mergers and Pre-merger Market Concentrationmentioning

confidence: 92%

“…The main costs identified as being potentially savable were management and back office costs, rather than a reduction in clinical costs. Economies of scale were rarely mentioned (Hutchings et al, 2003). Fig.…”

Section: Hospital Reconfiguration In the Ukmentioning

confidence: 99%

“…4 There are a small number of case studies of hospital mergers in the UK post 1997. Fulop et al (2002) and Hutchings et al (2003) undertake a case study of three (Fulop et al) and eight (Hutchings et al) mergers in one city (London). Their focus is on saving s in management costs post merger.…”

Section: Introductionmentioning

confidence: 99%

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Can governments do it better? Merger mania and hospital outcomes in the English NHS

Gaynor

Laudicella

Propper

2012

Journal of Health Economics

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The literature on mergers between private hospitals suggests that such mergers often produce little benefit. Despite this, the UK government has pursued an active policy of hospital mergers, arguing that such consolidations will bring improvements for patients. We examine whether this promise is met. We exploit the fact that between 1997 and 2006 in England around half the short term general hospitals were involved in a merger, but that politics means that selection for a merger may be random with respect to future performance. We examine the impact of mergers on a large set of outcomes including financial performance, productivity, waiting times and clinical quality and find little evidence that mergers achieved gains other than a reduction in activity. Given that mergers reduce the scope for competition between hospitals the findings suggest that further merger activity may not be the appropriate way of dealing with poorly performing hospitals.

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Section: Mergers and Pre-merger Market Concentrationmentioning

confidence: 92%

Section: Hospital Reconfiguration In the Ukmentioning

confidence: 99%

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Can governments do it better? Merger mania and hospital outcomes in the English NHS

Gaynor

Laudicella

Propper

2012

Journal of Health Economics

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“…In the shadow of literature on the relationship between mergers and efficiency (Harris et al , 2000; Kjekshus and Hagen, 2007), prices and costs of services (Carey et al , 2011; Hutchings et al , 2003) and competition and market power (Haas-Wilson and Garmon, 2011; Schmid and Ulrich, 2013; Schmid and Varkevisser, 2016; Varkevisser and Schut, 2012), several studies look into the effect of mergers on quality of care (Beaulieu et al , 2020; Dutch Authority for Consumers and Markets, 2016; Hayford, 2012; Ho and Hamilton, 2000; Mutter et al , 2011; Romano and Balan, 2011). These studies operationalise the quality of care by comparing a set of quality indicators pre- and post-merger, testing for differences.…”

Section: On Hospital Mergers Quality Of Care and Regulationmentioning

confidence: 99%

Disruptive life event or reflexive instrument? On the regulation of hospital mergers from a quality of care perspective

Kam

Bochove

Bal

2020

JHOM

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PurposeDespite the continuation of hospital mergers in many western countries, it is uncertain if and how hospital mergers impact the quality of care. This poses challenges for the regulation of mergers. The purpose of this paper is to understand: how regulators and hospitals frame the impact of merging on the quality and safety of care and how hospital mergers might be regulated, given their uncertain impact on quality and safety of care.Design/methodology/approachThis paper studies the regulation of hospital mergers in The Netherlands. In a qualitative study design, it draws on 30 semi-structured interviews with inspectors from the Dutch Health and Youth Care Inspectorate (Inspectorate) and respondents from three hospitals that merged between 2013 and 2015. This paper draws from literature on process-based regulation to understand how regulators can monitor hospital mergers.FindingsThis paper finds that inspectors and hospital respondents frame the process of merging as potentially disruptive to daily care practices. While inspectors emphasise the dangers of merging, hospital respondents report how merging stimulated them to reflect on their care practices and how it afforded learning between hospitals. Although the Inspectorate considers mergers a risk to quality of care, their regulatory practices are hesitant.Originality/valueThis qualitative study sheds light on how merging might affect key hospital processes and daily care practices. It offers opportunities for the regulation of hospital mergers that acknowledges rather than aims to dispel the uncertain and potentially ambiguous impact of mergers on quality and safety of care.

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“…Mergers between service-producing entities involve major organizational changes introduced with the objective of making services more efficient and effective (Bachiller & Grossi, 2012;Mussari & Ruggiero, 2017). Mergers between hospitals, resulting in larger organizational forms, are a growing trend in the United States and in most European countries (Ferreira, Marques, & Nunes, 2018;Hutchings et al, 2003;Loss et al, 2018;Preyra & Pink, 2006). These reform processes and the outcomes of mergers are also discussed in the research literature (Choi, Holmberg, Löwstedt, & Brommels, 2011;Schmitt, 2017;Solstad & Pettersen, 2010).…”

Section: Introductionmentioning

confidence: 99%

Hospitals as professional organizations and the perception of distances

Solstad¹,

Pettersen

Robbins

2020

Financ Acc Manag

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Management at a distance is increasingly employed to organize hospital resources, of which professionally skilled staff is the key component. Mergers often imply distant management. The study examines the internal management aspects for two hospitals in two consecutive mergers, 5 years apart. We focus on how geographical and cognitive distances are experienced by middle managers and their followers. We find that the concept of distance plays significant and different roles in managing units in an organization with distant top management teams. Our findings indicate that hospital professionals' positive perception of their relationship with top managers, as measured by cognitive distance, can outweigh the possible negative effects of large geographical distances between hospital units and top management teams. Our study also indicates that information systems and communication mechanisms may mitigate the possible perceived negative effects of distance. Our findings imply that politicians, policymakers, and National Health Service' management should be aware of the effects of distances in implementing new collaborative management arrangements. We recognize that our study is limited in context, time, and scale. We welcome further research on comparative analyses of the complex interplay between physical and cognitive distances in other hospitals and also other types of organizations. K E Y W O R D S hospitals, management, merger, physical and cognitive distances This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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The Process and Impact of Trust Mergers in the National Health Service: A Financial Perspective

Cited by 6 publications

References 5 publications

Can governments do it better? Merger mania and hospital outcomes in the English NHS

Can governments do it better? Merger mania and hospital outcomes in the English NHS

Disruptive life event or reflexive instrument? On the regulation of hospital mergers from a quality of care perspective

Hospitals as professional organizations and the perception of distances

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