The Competition and Markets Authority has cleared a merger between Heart of England NHS Foundation Trust (HEFT) and University Hospitals Birmingham NHS Foundation Trust (UHB).

While the marriage could give rise to competition concerns across a number of elective specialties, “these were outweighed by the substantial improvements to patient care that were expected to arise, the Authority said.

NHS Improvement advised that HEFT had experienced “sustained difficulties in governance, quality of care and finances since 2012, which successive management teams had been unable to address,” and that the appointment of UHB management to HEFT’s executive team in October 2015 “has already given rise to a number of benefits, such as reduced waiting times and improvements in the quality and safety of patient care for all HEFT patients”.

However, these improvements and a number of other longer-term benefits “would disappear without the merger and the continued presence of the UHB management at HEFT.”

On the basis of the available evidence, it was decided that the merger would not be referred for an in-depth investigation.

“This is the first time the CMA has cleared an NHS hospital merger on the basis of patient benefits at phase 1 and reflects the quality of the benefits case put forward in this instance and the consistent and detailed advice of NHS Improvement,” said Kate Collyer, deputy chief Economic Adviser and the decision maker in the case.

“Competition currently plays a limited role in the NHS, as health commissioners and regulators have instead emphasised co-operative working to handle growing demand for NHS services.

“However, given the scale of the potential impact on patients in Birmingham and Solihull, it was appropriate for the CMA to examine this transaction to determine whether any loss of choice or competition would be outweighed by improvements undertaken by the Parties and overseen by NHS Improvement,” she noted.