Proposals to merge Burton's Queen's hospital into the Royal Derby have taken an important step forward.
The chief executives of Burton Hospitals NHS Foundation Trust Helen Scott-South and her counterpart at Derby Teaching Hospitals NHS Foundation Trust Gavin Boyle have confirmed the plans would see Derby "acquire" Burton. They were speaking at a public meeting to discuss the plans held at Queen's Hospital on Tuesday, July 4. There they revealed that final planning for the move is set to be submitted and reviewed in November.
Affected hospitals include the Royal Derby Hospital and Queen’s Hospital, in Burton, along with a number of community hospitals under the respective trusts umbrellas, including Sir Robert Peel Community Hospital in Tamworth and Samuel Johnson Community Hospital, in Lichfield which belong to the Burton trust.
Importantly it was confirmed at the Healthwatch Conference for Staffordshire meeting that the plan would be to keep Burton's accident and emergency department open, as Derby would be unable to cope with a huge influx of people from Burton, so Queen's A&E is vital to the proposals.
Both bosses said they feel the move will make both trusts stronger as being bigger meant they could continue to offer many the health services on offer now.
Rumours about a possible merger have been circulating since early 2016 when Mrs Scott-South, then having just been appointed, refused to rule out the possibility of the two NHS trusts in Burton and Derby joining forces.
Then earlier this year there were concerns the accident and emergency department at Queen's Hospital, in Belvedere Road, might be down-graded to a urgent care centre, meaning it would not operate 24-7. The Burton Mail, as well as the town's MP Andrew Griffiths, joined the fight to keep it open. It later transpired that it was set to be saved.
Outraged residents signed a petition calling for the department to remain with 50,000 calling for it to be saved.
The meeting was told two potential plans for merging the hospitals had originally be considered. The first would see the creation of a ‘group structure’, which would be a binding partnership of the two trusts, but they would remain separate entities. The second option which has been chosen is that the two combine to form one hospital trust.
Mr Boyle said the two organisations would be exploring a formed partnership that would see one hospital trust be created with a new name which had yet to be decided. Hospital bosses feel having one organisation will mean they can improve services.
He said: “We have now zeroed in on what we are talking about in the partnership. We have looked at half a dozen models, which we narrowed down to two that we could concentrate on.
“The first is forming a single organisation through a merger and the other is a group structure - where we would remain separate but try and work as if they are individual. When both trust boards considered the case we made a decision to focus on becoming a single organisation because we think that is the right thing to do to enable the improvements to services."
He said the group structure option was discounted because problems may have been encountered if the two trusts tried to be joined but individual at the same time.
He said: “The word merger is used very loosely because in the commercial world there are actually very few mergers. But a merger is when you dissolve two organisations then create a new one, which is legally very difficult to do.
“So as part of this proposal it is a merger through the routes of an acquisition; of Derby acquiring Burton.”
Many questions were raised regarding why the acquisition was that way round, rather than Burton taking over Derby, but executives claimed that due to economic reasons, it was far easier and cheaper to merge through Derby.
Similarly the newly formed trust would be able to keep the ‘teaching’ title from Derby that will let the hospitals continue to attract high calibre nursing professionals.
Moving forward the two trusts would form their final plans for the acquisition and submit them by November, which will then be consider by the councils of governors from both trusts.
The Government-run group NHS Improvement, which responsible for overseeing trusts and their development to improve, will have to approve the plans.
Finally the Competition and Markets Authority which regulates and strengthens business competition will have to consider the plans before it is approved, the meeting was told.
What’s in it for Burton?
Almost all services currently on offer at Queen Hospital will remain in Burton despite the acquisition, other than stroke services will go to Derby, which has an admired department in dealing with stroke patients.
Mr Boyle said, although Burton is merging into Derby, the benefits will be equally felt by both trusts.
He said: “Bringing our clinical teams together to create a larger team will make them more resilient and able to sustain services here in Burton and be able to do that on a broader base. With a larger clinical team it will be easier to lead that challenge.
“We all know questions have been raised about the sustainability of some of the local services in Burton, but one of the principle aims of the partnership is to secure those services and make sure we keep them here for local people. The main win for Burton is all about sustaining local services.”
Mrs Scott-South mirrored Mr Boyle’s comments, saying the merger will only allow for more consultants to be available at Burton.
She said: “From our point of view with the collaboration with Derby, the benefit is that we believe we will get more consultants who can then offer services as outpatients in both hospitals, which is a really important factor here.
“We want to offer services in both hospitals to then bring money back to the area. An angle of competition will also be added in which will be seen as a good thing.”
What’s in it for Derby?
As the chief executive for Derby Teaching Hospitals, Gavin Boyle went into detail regarding how the merger would benefit the Derby-based trust.
He said that increasing the size of the population that the hospital trust is responsible will aid Derby, as more funding can be obtained for dealing with more patients in each specialised area.
He said: “As a teaching hospital not only do we provide district general services, but we also provide about 40 specialist services and the challenge of this is providing them for a much bigger population, because for specialties there are fewer people requiring the services.
“So you need to serve a bigger population in order to generate sufficient activity so that the clinical people delivering the services maintain their competence.
“One of the challenges we face as a training hospital is our actual population isn’t big enough so we can’t be confident of sustaining those services. The quality of those services is very good but are provided against the national specification that includes laws about population size and rules and procedures.
“For example, upper GI cancer (upper gastrointestinal) is an important specialist service that we provide and we did that very well but the magic number in the national specification is 60 cases a year, last year we did 57 cases. But seven cases went from Burton to other places so through the partnership that could have kept them ‘in the family.”