A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...

Board of Directors Part 114 June 2013The proposed merger of The Royal Bournemouth and ChristchurchHospitals NHS FT and Poole Hospital NHS FTThe Trusts are due to hold second separate hearings with the CompetitionCommission on 11 June. These discussions will principally focus on the areas ofoverlap between the two organisations, the CC’s attempt to define our market, thecounterfactual, maternity services and the competitive effect on elective services.At this stage the emerging CC papers argue the Trusts provide a range of serviceswhich they do not. This is despite clear evidence to the contrary. It is cruciallyimportant that the lay panel are fully aware of this fact as otherwise the degree ofoverlap is overstated. This has emerged as a result of the CC seeking toreapportion patient activity attributed to general medicine and general surgery. Afull update on the hearing will be given at the Board meeting.Once concluded the Trusts expect to receive, by the end of June, the provisionalfindings of the Competition Commission. This will then generate a series ofdiscussions regarding potential remedies which the CC would see as an importantmeans of mitigating any perceived significant lessening of competition. From thework that has been undertaken to date the areas it is most concerned about relateto elective and maternity services.An important recent development has been an acknowledgement from Monitor thatin the absence of merger and financial support from the CCG, (which they are clearwill not be forthcoming), then Poole will face very significant financial pressures.The Competition Commission had previously argued that this was unlikely to impacton the future of the Trust; Monitor are, however, clear in view of recent informationprovided to them by Poole Hospital, that this will create significant pressure. TheCC will need to weigh this development very carefully in considering any potentiallessening of competition.Work continues now led by Mary Sherry to develop a more detailed set of plansunderpinning the likely savings to accrue as a result of the merger. It is importantthat all directorates are able to complete their Post Transaction Integration Plans(PTIPs) and detail savings/efficiencies that will be generated in 2014/15 and2015/16. The two Trusts are currently working to identify whether the savings aresufficient to maintain a balanced financial position for any new merged organisation.Monitor will want to be satisfied that the new organisation is financially viable. It ispossible that further discussions will be required with commissioners concerning theneed to provide transitional support for the new organisation. These discussionshave not yet taken place but will be important in helping maintain the financial healthof a new organisation. The Cost Improvement Plans of each directorate will bereviewed in detail on 1 and 2 July. This scrutiny is critical to ensure that we haverobust plans going forward and these will be independently tested through KPMGand Monitor’s assessment of the proposed organisation.Work will commence in the Autumn to determine the options to be put forward forconsultation with regard to the future configuration of a range services includingthose previously discussed. It is important for me to emphasise that no decisionshave been taken with regard to the future siting of services and both TMB and HEGProposed Merger Page 1 of 2Strategy