NPM merger mania Lessons from an early case

A central doctrine of NPM requires the adoption of commercial management techniques to address the espoused goals of saving money and improving collaboration and service co-ordination. This article examines the evidence base for NPM mergers and uses study data to explain how two ingrained features of professional work helped to produce unintended outcomes at an early UK case involving a specialist mental health provider and an acute trust. The emergence of a de facto mental health trust within the merged entity arose from senior professionals' capacity to ‘buffer’ the work of colleagues from the rationalizing spectre of the merger. The persistence of ‘loosely coupled’ practices and structures restricted improvements in collaboration and service co-ordination. It is argued that these two enduring characteristics of professional organization will shape the outcomes of future NPM mergers in mental health care e.g. the creation of social care trusts and mental health ‘super-trusts’) and in other fields such as higher education.