Merger and post-merger integration at Oxford University Hospitals: mixed-methods evaluation and lessons learned
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 13 January 2022
Issue publication date: 2 June 2022
Abstract
Purpose
Hospital mergers are common in the United Kingdom and internationally. However, mergers rarely achieve their intended benefits and are often damaging. This study builds on existing literature by presenting a case study evaluating a merger of two hospitals in Oxford, United Kingdom with three distinct characteristics: merger between two university hospitals, merger between a generalist and specialist hospital and merger between two hospitals of differing size. In doing so, the study draws practical lessons for other healthcare organisations.
Design/methodology/approach
Mixed-methods single-case evaluation. Qualitative data from 19 individual interviews and three focus groups were analysed thematically, using constant comparison to synthesise and interpret findings. Qualitative data were triangulated with quantitative clinical and financial data. To maximise research value, the study was co-created with practitioners.
Findings
The merger was a relative success with mixed improvement in clinical performance and strong improvement in financial and organisational performance. The merged organisation received an improved inspection rating, became debt-free and achieved Foundation Trust status. The study draws six lessons relating to the contingencies that can make mergers a success: (1) Develop a strong clinical rationale, (2) Communicate the change strategy widely and early, (3) Increase engagement and collaboration at all levels, (4) Be transparent and realistic about the costs and benefits, (5) Be sensitive to the feelings of the other organisation and (6) Integrate different organizational cultures effectively.
Originality/value
This case study provides empirical evidence on the outcome of merger in a university hospital setting. Despite the relatively positive outcome, there is no strong evidence that the benefits could not have been achieved without merger. Given that mergers remain prevalent worldwide, the practical lessons might be useful for other healthcare organisations considering merger.
Keywords
Acknowledgements
The authors gratefully acknowledge Dr Tony Berendt, Jan Fowler, Jennifer Howells, Sara Randall, Bev Edgar, Andrew Stephens, and Dr Kristin-Anne Rutter, who provided guidance and advice as members of the Study Steering Group. PO is funded by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, grant BRC-1215-20008 to the Oxford University Hospitals NHS Foundation Trust and the University of Oxford. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
Citation
Maile, E.J., Mitra, M., Ovseiko, P. and Dopson, S. (2022), "Merger and post-merger integration at Oxford University Hospitals: mixed-methods evaluation and lessons learned", Journal of Health Organization and Management, Vol. 36 No. 4, pp. 503-520. https://doi.org/10.1108/JHOM-01-2021-0024
Publisher
:Emerald Publishing Limited
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