Statutory transactions

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NHS England is responsible for approving statutory transactions having first been satisfied that the transacting trusts have taken the necessary steps to prepare for the transaction. We aim to ensure that the proposed transaction is the right solution to the issues it is attempting to address and that the intended benefits will be delivered.

Statutory transactions are those governed by the NHS Act 2006 (the Act) and incorporate:

  • Mergers (section 56)
  • Acquisitions (section 56A)
  • Dissolutions (NHS trusts – schedule 4; foundation trusts – section 57A)
  • Separations (section 56B)
  • Transfer schemes (section 69A)

All statutory transactions are reportable, regardless of their size.

We will apply our risk assessment framework to each transaction to determine the level of risk and therefore the extent of assurance work required. We will classify transactions as either ‘material’ (lower risk) or ‘significant’ (higher risk).

Trusts should contact NHS England regional colleagues at the earliest opportunity when considering a transaction, so that we can provide advice and support as the proposals are developed.

The guidance below replaces the 2017 transactions guidance, having been subject to consultation in 2021. Where trusts have started but not yet completed a transaction process under previous guidance, we will discuss the applicability of this revised guidance on a case-by-case basis.

Please contact for more information.


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