Integrated Care & Social Care

'Not just another NHS merger'

Adam Hewitt reports on the accelerating plans for a single new academic healthcare organisation for London.

Three major foundation trusts in London and a university partner have decided to press ahead with plans to merge into a single organisation, creating a unique new academic health institution.

The business case is being prepared by King’s Health Partners Academic Health Sciences Centre (AHSC) – one of five such centres in the country – following unanimous endorsement of this approach from the trusts and hospitals involved: Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley NHS foundation trusts, along with King’s College London.

The new institution would provide both physical and mental healthcare across scores of sites and facilities in the capital, and have a strong academic ethos, while also attracting the world’s best clinical and academic staff.

The King’s Health Partners Board is now preparing a ‘strategic outline case’, investigating the benefits, costs and risks of establishing a single organisation in more detail.

Academic participation

The recommendation followed a review which was commissioned by the Partners Board last autumn to look at different models for the future development of the AHSC and explore how greater academic participation with King’s College London could be achieved.

The primary vehicles through which clinical care, research education and training will be integrated across the partners are the ‘Clinical Academic Groups’, on which “much progress” has been made, the partners say.

Staff, patients, governors, partner organisations and others have been sent a briefing outlining the AHSC’s ambitions to create a single entity that will drive innovations and improve the quality of research, education and training and the delivery of care to local patients. The next step will be to discuss the proposal more widely with them.

‘A totally new type of organisation’

Professor Robert Lechler, executive director of King’s Health Partners, said: “What we are considering isn’t just another NHS merger – not only are we approaching this from a position of strength financially, but we will be creating a totally new type of organisation that brings closely together mental and physical healthcare with research, education and training at its highest level. Working as one, alongside our university partner King’s College London, will mean we have the potential to fully transform the delivery of healthcare to our local patients and beyond, creating a system rated amongst the best in the world.

“This is a hugely significant moment for our AHSC. However, it is only the first step along the road to integration. As we develop the strategic outline case, we will be engaging with staff and patients as well as healthcare providers and commissioners in south London to ensure that our new organisation is able to deliver the very best patient care possible and speed up the time it takes for research discoveries to become routine clinical practice.”

He said the partnerships brings together an unrivalled range and depth of clinical and research expertise, driving improvements in care for patients, allowing them to benefit from breakthroughs in medical science and receive leading edge treatment at the earliest possible opportunity.

Care closer to home

The partners are keen to move towards a different model of healthcare, focused more on keeping people healthy and independent, and avoiding the need for interventions and expensive acute care. A closer alignment with social care delivery organisations, they say, can bring care closer to home for patients, improving their own quality of life while also allowing NHS resources to be better prioritised.

In a briefing note, the partners said academic research can help to achieve this. They say: “We will harness our research talents to create, to assess and to refine these new models to improve health for the population we serve.

To create these new models of care will require greater flexibility in the use of our assets and resources across the partners than is possible with today’s organisational structures. By combining our strengths we will also create the capacity to offer outstanding specialist services at the scale that matches international competitors.”

Once the strategic outline case has been prepared, the trusts’ and college’s governing bodies and boards will review the proposal, and will only proceed if it shows “significant” benefits for the public, and if the many legal and regulatory requirements can be met.

The partners are also pushing ahead with other recommendations in parallel with the main merger proposal; these are to embed an academic–clinical co-leadership model across the partnership, to modify the King’s Health Partners Board to include additional senior academic representation, to develop a set of actions that will further strengthen the academic ethos across the partners, and finally to define and fund a set of programmes that will help accelerate the King’s Health Partners’ strategy.

The AHSCs

The UK’s five academic health science centres were accredited in March 2009, with an intention to emulate leading global institutions set up on this model like Johns Hopkins Medicine in the USA and Karolinska Institutet in Sweden.

Two of the others are in London – Imperial and UCL – while the final two are in Cambridge and Manchester. The five AHSCs are at different stages of integration and development.

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