NHS Trust Mergers

GUIDANCE ON NHS TRUST MERGERS AND THE CONCLUSION OF HOSPITAL PROVIDER SPELLS

    Introduction
  1. This guidance explains the circumstances under which Hospital Provider Spells should close and reopen as a result of a merger or demerger, in terms of NHS data standards. It specifies which codes should be used for those Hospital Provider Spells which must be closed and reopened,

    - For Discharge Destination, etc, for the closing Hospital Provider Spell, and
    - for Source of Admission, etc, for the new Hospital Provider Spell.

    Note that the NHS-wide Clearing Service (NWCS) has also issued Guidance Note NWCS/GN-003 which explains the use of NWCS Exchange Protocols when NHS Trusts merge.

    When Hospital Provider Spells Should be Closed and Reopened
  2. A Hospital Provider Spell is provided by one Organisation acting as a Health Care Provider. This means that the spell is linked to the Organisation Code of the provider. If the Organisation Code changes, the spell must end and another begin with the new Organisation Code. If the spell does end, the Consultant Episode Hospital Provider within the spell must also end.

    The following scenarios explain what this means in terms of NHS Trust mergers or demergers. Note that these assume that nothing changes other than the fact that the NHS Trusts merge or demerge, e.g. the Consultant stays the same, etc.

    Mergers

    a. Trust A merges with Trust B to produce Trust C, which has a new Organisation Code. The Organisation Code will change for both Trust A and B. Therefore Hospital Provider Spells in both Trust A and B should close, and new spells should be opened using the new Organisation Code for Trust C.
    b. Trust A merges with Trust B to produce an organisation which uses Trust A's Organisation Code. For those Hospital Provider Spells in Trust A, the Organisation Code will not change. Therefore Trust A's Hospital Provider Spells should not be closed just as a result of the merger. However, for Trust B the Organisation Code will change. Therefore Hospital Provider Spells in Trust B should close, and new spells should be opened using the new Organisation Code for Trust A.

    Demergers

    a. Trust A splits into Trust B and Trust C, both of which have a new Organisation Code. The Organisation Code will change for both Trust B and C. Therefore all Hospital Provider Spells in Trust A should close, and new spells should be opened in Trust B and C using the new Organisation Codes for each.
    b. Trust A splits into Trust B and C. Trust B retains Trust A's Organisation Code and Trust C is issued with a new one. The Organisation Code for Hospital Provider Spells in Trust A which are taken over by Trust B will not change. Therefore they should not be closed just as a result of the merger. However, Trust A's Hospital Provider Spells which are taken over by Trust C should close, and new spells should be opened using the new Organisation Code for Trust C.
    The Codes Used when Hospital Provider Spells are Closed and Reopened
  3. If Hospital Provider Spells are to be closed and reopened only as a result of NHS Trust mergers or demergers, for most cases the codes below should be used.

    The CLOSED Hospital Provider Spell

    DISCHARGE DESTINATIONS
    This depends on the type of ward the patient is in, but will be either

    51 NHS hospital provider - ward for general patients or the younger physically disabled
    52 NHS hospital provider - ward for maternity patients or neonates
    53 NHS hospital provider - ward for patients who are mentally ill or have learning disabilities

    DISCHARGE METHOD

    1 Patient discharged on clinical advice or with clinical consent

    The REOPENED Hospital Provider Spell

    ADMISSION METHOD

    81 Transfer of any admitted PATIENT from other HOSPITAL PROVIDER other than in an emergency

    Note that this Admission Method is classed under `Other Admission'. It is not elective and the patient does therefore not have an entry on an Elective Admission List.

    SOURCE OF ADMISSIONS
    Again, this depends on the type of ward the patient is in, but will be either

    51 NHS hospital provider - ward for general patients or the younger physically disabled or A & E department
    52 NHS hospital provider - ward for maternity patients or neonates
    53 NHS hospital provider - ward for patients who are mentally ill or have learning disabilities

    REFERRER CODE
    This will be the referrer to the Hospital Provider Spell within which the patient was receiving care before the merger, i.e. the `original' Hospital Provider Spell.