Foundation trusts may consider entering into transactions in order to, among other things, help improve the quality of services, create greater choice for the public or improve the personalisation of services.
These transactions can have a significant impact on trusts’ operating and risk profiles. Monitor therefore expects trust boards to have obtained appropriate assurance before entering into such transactions.
Large-scale mergers and acquisitions have inherent risks and Monitor’s role in this area is to ensure that NHS foundation trusts do not jeopardise their quality of services or financial stability. We ensure that foundation trusts understand the risks and, where necessary, mitigate them. We do this by providing indicative risk ratings of major transactions, leaving boards to put in place strategies and mechanisms to mitigate any material risks. We are seeking to reduce any disincentives to transactions resulting from our processes, to ensure that NHS foundation trusts have the confidence to innovate and move forward.
The Co-operation and Competition Panel (CCP) provides advice to Monitor in relation to cases under the Principles and Rules of Cooperation and Competition that involve NHS foundation trusts. We have published a summary of the cases where the CCP has made a recommendation to Monitor and the action we have taken.