What are we trying to do?
We want to explore the extent to which the reconfiguration of hospital services and management following the mergers of hospital trusts in England has impacted healthcare costs and activity.

 

 

Why is this important?
Hospital trusts in the English NHS have regularly merged to form larger organisations with the aim to improve efficiency, reduce costs, and redistribute activity. Understanding the impact of these mergers is important because reconfiguring hospital services and management is a time-consuming and costly process. However, little is known about how reconfiguration impacts hospital spending and activity across different services and over time.

 

The results from this work will provide insights into the consequences of hospital mergers to inform future healthcare policy and service planning. 

 

 

How are we doing it?
We are investigating the impact of 4 high-profile mergers between 8 acute hospital trusts in England that occurred between April 2017 and October 2018.

 

To do so, we use annual data from the National Cost Collection Index (NCCI) on 105 hospital trusts between 2013/14 and 2019/20. These data are reported by trust, department, specialty, and procedure and contain information on the:

 

• total cost 
• unit cost
• volume of care provided.

 

We estimate the impact of each hospital merger on these 3 outcomes using a ‘matching difference-in-differences’ method. This method allows us to compare merging and non-merging hospitals with similar services and underlying costs.

 

The findings from these analyses will allow us to examine the cost and activity implications of hospital reconfigurations across different services and types of mergers.

 

 

More information

 

 

Senior Programme Lead
Mike Spence
Michael.spence@manchester.ac.uk