UK Veterinary Care – Competition Risk Assessment

Rapid consolidation in recent years has seen national chains of vet practices become established. These chains have built up strong local positions in several parts of the UK. Aldwych Partners considers that there is an increasing risk of the Competition and Markets Authority (CMA) reviewing further expansion by these chains. This could include acquisitions of…

A tough CMA review ahead for Sainsbury’s and Asda

The CMA, in fast-tracking its review of the Sainsbury’s/Asda merger to a detailed second phase, found that there was a realistic prospect of competition being lost in 463 local areas, and flagged at least seven ways in which consumers might be harmed by the merger. While these early findings need to be treated with caution,…

CMA clearance for child fostering mergers

Last year saw the CMA’s first review of a merger in child fostering services. These businesses place children with foster parents when a local authority cannot place a child using its own in-house service. The merger was cleared on the condition that services were divested in three regions. Now, with two fostering services businesses (Core…

Unintended effects of limiting out of area placements?

NHS mental health trusts could, according to a report in HSJ, face regulatory action for not reducing the time patients spend in units a long way from home (known as ‘out of area placements’). There is little to argue about with a policy that is aimed at ending by 2020/21 what are known in NHS-speak…

Competition from app-based GP services poses challenge for CMA

NHS England has announced the piloting of an app that allows patients to access a GP through their smartphone. GP services offered through the app will compete with existing bricks and mortar services, and represents a massive injection of competition into primary care services. Patient migration to the app-based service will leave existing GP practices…

Making more NHS mergers more successful

NHS merger activity has increased markedly in the past 12 months. The Competition & Markets Authority (CMA) has just cleared major transactions in Manchester and Birmingham, and further NHS mergers are planned in Essex, Gloucestershire, Dorset, and elsewhere. Everyone in the NHS knows that while mergers can provide opportunities for significant service improvements, they also…

Joint bidding as a competition issue

Late last month the Competition & Markets Authority (CMA) published an open letter to public sector procurement officials with advice on how to spot bid rigging. Bid rigging is rightfully regarded as a very serious offence. When bidders collude to share contracts and/or make purchasers pay more, their behaviour is little more than theft. The CMA’s advice…

Brexit and NHS competition and procurement rules

Brexit’s impact on the regulation of NHS procurement and competition, as foreshadowed in HSJ last Friday, is likely to be limited. At the risk of unnecessarily adding to the volume of Brexit-related discussions, this blog post looks in further detail at the likely impact on procurement, merger control, state aid and prohibitions on anticompetitive behaviour in…

How much does competition influence Acute Trust behaviour?

Merger analysis is about assessing how much competition will be lost if two organisations merge, and deciding whether this matters. My last blog talked about how GP referral analysis could be used to answer this question for NHS hospital mergers. Analysing NHS hospital mergers, however, is different to most non-NHS mergers because deciding whether a…

Using patient referrals to analyse hospital competition

This week the Health Foundation hosted a panel discussion which looked back on the Competition & Markets Authority (CMA) review of the planned merger between Ashford & St Peter’s Hospitals NHS Foundation Trust (ASP) and Royal Surrey County Hospital NHS Foundation Trust (RSC). The CMA, Monitor and the two Trusts reflected on the case and…