CMA suggests hospital mergers could increase mortality rates

Merging hospital trusts could significantly increase mortality rates according to new analysis from the Competition and Markets Authority

The study “Does hospital competition reduce rates of patient harm in the English NHS?” identified an average cost of more than £2.5m a year to the NHS from a typical merger as a result of the harms.

The CMA study reported: “We find a significant inverse relationship between concentration and quality. Specifically, our estimates imply that a hypothetical merger to monopoly would, on average, be associated with a significant increase in harm rates. This increase becomes smaller when more competitors remain post-merger. The economic and statistical significance of this effect is robust, including when we consider the effect of mergers on in-hospital mortality.”

“If the harm rate were to increase by 41 per cent as a result of a representative merger affecting all specialties in the hospitals, across both trusts involved, this would give an additional annual cost of £2.5m per year counting only the four harm types.”

The study used a new methodology for evaluating the impact of competition, examining rates of falls, pressure ulcers, blood clots and urinary tract infections across eight separate hospital specialties.

Hospital episodes statistics from 2013-14 and 2014-15 awere used, and compared harms rates in each department and trust alongside the number of distinct organisations nearby.