Why we’ve merged and what it means for you
Our aim is to deliver outstanding care for local people as we bring together the expertise of our 12,000 staff across our five hospital sites.
Who we are
Derby Teaching Hospitals NHS Foundation Trust (DTHFT) and Burton Hospitals NHS Foundation Trust (BHFT) have merged to become a new organisation – University Hospitals of Derby and Burton NHS Foundation Trust.
DTHFT provided care for around 600,000 people around southern Derbyshire over two sites – the Royal Derby Hospital and the London Road Community Hospital – with over 8,500 staff.
BHFT provided services for around 360,000 people in Burton upon Trent and south Staffordshire. As well as Queen’s Hospital in Burton, it ran the Sir Robert Peel Hospital in Tamworth and the Samuel Johnson Hospital in Lichfield with over 3,000 staff in total.
The case for change
There are many reasons why bringing the two hospital Trusts together is a good idea for patients and staff. Some services at Burton have a low volume of clinical activity and therefore difficulties in maintaining a stable, fully established and multi-professional workforce. An increased population of patients will help to solve this problem. Highly specialised services, such as cancer surgery provided in Derby, require minimum numbers of patients, so increasing the population covered will have a positive effect on this. Bringing teams together to provide care for larger populations will also help with staffing issues such as emergency cover. A large University Hospital Trust is more attractive to new staff and provides more opportunities to existing staff. The merger will improve local access to services, not just in Burton and Derby, but also for Tamworth and Lichfield. Both Trusts had challenging financial issues with deficits at the end of last financial year and merging provides the opportunity to reduce duplication and make savings.
Changes to clinical services
Our priority is to ensure that all clinical services continue to operate safely and effectively from 1 July 2018. However, over time we will be able to make the changes we need to realise all of the benefits for our patients, and continue to improve the opportunities for our staff. Some services have already been reviewed in detail so that we can start to make some of these changes more quickly.
We will provide a single cardiology service with consultants working across both Burton and Derby hospital sites. This will mean care closer to home, including the fitting of pacemakers, and ensure that patients can receive more treatments in one place without the need for further referrals. Other benefits include:
- Access to services 7 days a week
- Both sites will be able to provide a fuller range of cardiac services
- Better ‘out of hours‘ cover.
The orthopaedic department will become a larger, more resilient unit to compete with other large organisations nearby. The combined team will provide services across a wider range of locations and will support quality and productivity improvements, reduced waiting times and improved satisfaction for both patients and staff. They will also provide:
- Better patient experience with more streamlined processes
- Specialist services on your door step
The proposed new cross site structures will reduce variation in how radiologists work, providing patients with a more consistent service. Other benefits include:
- Weekend access will improve due to increased capacity
- Reduced waiting times
- Improvements to cancer diagnostics
- Recruitment and retention of our increasingly talented staff will become easier
We propose to deliver a Hyper Acute Stroke Unit for the Burton population at the Royal Derby Hospital. After this time patients would be discharged home or transferred to Burton to complete their care and receive rehabilitation in an enhanced service. This would bring a number of benefits:
- Improved clinical outcomes as 24/7 Hyper Acute services are available to a larger population of patient
- Improved access to weekend clinics
- Patients will also get access to specialist consultant care 7 days a week
- Reduced waiting times and lengths of stay
- Better survival rates as patients have 24 hr access to a full stroke service
A number of the clinical teams that diagnose and treat cancer at Derby and Burton will merge into one team. This will help to improve job satisfaction by sharing best practice amongst clinicians, and enabling larger on-call rotas. Benefits for patients include:
- Shorter travel times as services are provided more locally
- More streamlined diagnostics for cancer patients
- A bigger and more sustainable service will help us recruit and retain talented staff
The merged Trust will expand the high-quality renal service currently provided in Derby – one of the leading renal medicine units in the country – to patients across the combined Burton and Derby area. This will bring real benefits to patients:
- Reduction in undiagnosed Acute Kidney Injury due to better diagnostic skills
- Improved outcomes for dialysis patients
- Time savings and quality of life benefits arising from having home dialysis
There are many other benefits which patients and staff will see over the coming months and years. Shared services such as Human Resources and Finance can be brought together, improving efficiency and removing duplication. Improvements in recruitment will not only build clinical leadership but also reduce reliance on locums. Derby’s research expertise will be available across the merged Trust, with more potential patients to recruit and potentially more clinical trials. A financial benefit of £23million has been identified as a result of the merger. This is in addition to existing planned savings, which will also be easier to achieve following the merger.
Want to download a copy of this information?
Full Business Case (FBC) - 9 March 2018
Appendices to Full Business Case (FBC)
Outline Business Case 2017
Strategic Outline Case 2016
Addendum to Full Business Case - Chapter 7
NHSI Control Total Offer - 24 May 2018
Appendices Pack 2017
Appendices Pack 2016
Explanatory Note regarding the Full Business Case (FBC) Chapter 7 (Finance)
In March 2018, the original Chapter 7 in the FBC required amendments to reflect the revised planning Guidance for 2018/19 and changes in the actual performance and operating circumstances during 2017/18. A further revision to the Addendum to Chapter 7 of the FBC was produced in May 2018 which provided updates on the:
- submission of Sovereign Operational Plans for 2018/2019 on 30 April 2018
- review of the impact of the delay on the savings and costs of the Merger
- finalisation of plans in order to be Control Total compliant in 2019/2020 under the current 2018/2019 planning rules, assuming the compliance regime and control totals stay as they are in 2018/2019.
In mid May 2018 Derby Teaching Hospitals NHS Foundation Trust received and accepted a revised Control Total offer from NHS Improvement (NHSI), therefore, key parts of the Addendum to Chapter 7 of the FBC were revised because this offer impacted on the Trust’s position as a sovereign organisation and the position for the merged Trust.
The FBC should be read in conjunction with the Revised Addendum to Chapter 7 and the NHSI Control Total update paper.