BOSSES of two hospital trusts have admitted a merger is increasingly likely amid the greatest financial crisis in the history of the NHS.

Discussions about the creation of one ‘super trust’ covering Poole and Bournemouth are now back on the cards - three years after it was blocked by the Competition and Markets Authority because it ‘would damage patients’ interests by eliminating competition and choice’.

It comes just days after a document revealed clinical chiefs in Dorset also want primary care providers to merge to create 'super surgeries' with up to 50,000 patients in a move that would see the number of GP sites reduced from 131 to between 36 and 69.

The Daily Echo can today confirm England's health chiefs have approved Dorset Clinical Commissioning Group's Clinical Services Review, a radical shake-up of health services in the county and the public consultation on the proposals is imminent.

Plans include designating Royal Bournemouth Hospital as the county’s major emergency hub with Poole Hospital for planned care and a 24 hour urgent care centre as well as a shake-up of the county’s community hospitals.

Radical action is needed after Dorset health chiefs have revealed 'a do nothing scenario' would lead to a financial gap of £158 million a year with a further £56 million shortfall on NHS England specialised services.

Chief executive of Poole Hospital Debbie Fleming said both trusts are ‘keen to proceed’ with the Clinical Services Review to ‘improve outcomes for our patients, improve access to care and allow us to use our limited clinical and financial resources more effectively' and conceded that a change in the organisational structure is 'likely.'

She said: “As services become more integrated, the arrangements for providing them will need to change, and this is likely to include changing organisational forms.

“The boards of both Poole Hospital NHS Foundation Trust and The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust recognise this, and as such, have continued to reconsider the question of merger.

“Both Trusts remain aware that there is a lot of work to be done before any changes could take place locally, given that merger was prohibited by the Competition Authorities in 2013.

“In addition there is also the consideration of the implications of the proposed local authority reconfiguration, which is currently under consultation.

“At this stage, the possibility of merging services and how this might happen continues to be discussed but no decisions –or indeed proposals – have been taken any further. Whatever the outcome, both Trusts remain confident that in working more closely together, we can continue to provide high quality, safe and affordable care to patients in Dorset now and in the future.”

Health officials ordered every part of the country to draw up five-year sustainability and transformation plans (STPs) in a bid to cope with mounting pressures across the NHS.

The Clinical Services Review forms part of the Dorset STP and if proposals go ahead and a merger of the trusts is approved, it is certain to mean job losses, particularly among non-frontline staff.

Last night, Dorset Healthwatch expressed alarm and called for bosses to do the best for patients.

Manager Martyn Webster said: “Bournemouth and Poole Hospitals spent a lot of time, energy and an estimated £5 million planning for a merger just 3 years ago, only to have their plans blocked by the Competition Commission, which concluded that the merger would "damage patients' interests". The Commission also expressed concern about whether the potential benefit of having a major A&E department at only one of the two hospitals would outweigh the potential harm to people living nearer to the other hospital.

“If the possibility of a merger is now on the cards again, it's up to the two hospitals to produce adequate evidence not only to the Competition Commission but, more importantly, to local people to convince them that any merger will improve services for patients at both hospitals, as well as save public money."

A NHS Improvement spokeswoman said: "NHS Improvement has not made any recommendation regarding a merger. We’ll continue to support the trusts and other local stakeholders as they develop plans to ensure the best solution for patients.

"The public consultation on the Clinical Services Review is due to start later this year which will be a key step in this process. We’ll explore with both trusts a range of options open to them in the context of the Competition and Market’s Authority (CMA) decision in 2013.”