• Merger between Royal Brompton and Harefield FT and Guy’s and St Thomas’ FT creates £2bn-turnover organisation
  • Move precedes planned move of Royal Brompton hospital from Chelsea to Waterloo
  • Proposal was criticised by north west London clinical and academic bodies

The merger of two foundation trusts to create the UK’s largest healthcare provider has been approved.

The board of Guy’s and St Thomas’ FT agreed to merge with the Royal Brompton and Harefield FT at a public meeting on Wednesday, with the new organisation coming into being in February. RBH’s governors will decide on the merger next week, ahead of applying to NHS Improvement for approval.

The merged trust will have a turnover of roughly £2bn and operate from four main hospitals sites across London — London Bridge, Waterloo, Chelsea, and Harefield — as well as the community services run by GSTT in the boroughs of Lambeth and Southwark.

The Royal Brompton is a specialist heart and lung trust with a significant income from research, education, and private work. Guy’s and St Thomas’ have a similar balance of work but on a larger scale and with secondary and community services also.

NHS England and NHS Improvement, which scrutinises trust mergers, has not deemed the £2bn merger” significant” and so has not carried out its own investigation into the move.

‘Terrifically exciting’

At Wednesday’s board meeting, GSTT’s deputy chief executive Lawrence Tallon said the strategic rationale for the case was a “terrifically exciting one”, adding: “The core concept is that, by combining the scale and the specialisation of our two organisations, we can create an organisation — one of the largest and most successful academic systems, we believe, in the country — and something really of global significance…

“Scale on its own isn’t everything, of course, but the deep expertise we have within our organisations [means] we will be able to attract in future and working with our excellent academic partners not just in King’s College Hospital but with continuing relationships into Imperial, and indeed other partners, we have a terrific opportunity to really be on the global stage.”

RBH’s council of governors will meet to discuss and vote on the merger next week.

Managers working on the deal have been keen to stress the move would not end clinical and academic partnerships with Imperial College Healthcare Trust and its associated university as it became part of GSTT and the King’s Health Partners academic health science centre.

The two trusts provide most of England’s extra-corporeal membrane oxygenation services, which have been important in the NHS’ response to covid-19.

The move also solves a long-standing problem for the Royal Brompton over the provision of congenital cardiac surgery services.  As GSTT also provides these services, the two organisations’ combined volumes will clear the threshold.

The press release says: “The boards of both trusts are confident that by formally bringing together our respective organisations and the shared expertise of our clinical and academic teams, we can significantly improve care and outcomes for people with cardiovascular and respiratory disease. This ambitious venture, in partnership with King’s College Hospital NHS Foundation Trust and our academic partners, will create a centre of national excellence for the care of adults and children, which will sit at the heart of a population health system working together to significantly reduce the burden of these conditions.”

The statement describes the move as “wholeheartedly welcome” and says the trusts will be “taking this forward with our NHS partners and with King’s College London and Imperial College London”. It promises that further details of the transaction, the process, and the next steps will be set out in a “letter of intent” between the trusts, which is expected to be agreed shortly.