Hospitals in Oxfordshire are planning to form a new ‘super trust’ in a major reorganisation of the county’s hospital services, The Oxford Times can reveal today.

The shake-up will secure the specialist services at Oxford’s world-famous Nuffield Orthopaedic Centre, while creating one of the biggest providers of healthcare in the country, say health managers.

With some of the toughest years in the NHS’s history beckoning, proposals are being drawn up to integrate the Oxford Radcliffe Hospitals Trust (ORH) and the NOC into an expanded hospital trust, still to be named.

The reorganisation would produce major savings and cutbacks in senior management and office staff, while allowing Oxford’s main hospitals to finally realise their ambitions to become foundation trust hospitals.

Under the plan the different hospital sites — the John Radcliffe, the Churchill, the Horton in Banbury and the Nuffield Orthopaedic Centre — would all retain their names and separate identities.

But the shake-up would see the NOC disappear as an independent trust, having been in the first wave of NHS hospital trusts created in 1981.

Faced with a likely drop in income and reductions in patient numbers, the NOC, as a small specialist trust, was viewed as especially vulnerable in the current economic climate.

Two years ago, a key report found that the NOC trust was no longer financially viable in the face of mounting competition from a new local private treatment centre. It is now making small surpluses.

But NOC chief executive Jan Fowler said that despite the recent improvement in fortunes, it would have been difficult to deliver a sustainable business model with severe NHS funding constraints ahead.

She said: “The proposed integration seeks to create an organisation with greater resilience in the current economic climate and with the potential to deliver a successful foundation trust application.

“By joining forces, the NOC and the ORH can harness the joint expertise and natural clinical synergies between the organisations.

“I would want to reassure our patients and people of Oxfordshire that they will not be losing any of the services currently provided by the NOC at our Windmill Road site in Headington.”

She said there would be “scope for savings and reductions in the workforce”. But she added that any rationalisation was likely to impact on admin departments rather than clinical staff.

Staff in the county’s hospitals were this week being told about the proposal, which is backed by both trust boards.

Sir Jonathan Michael, the ORH chief executive, said: “Both organisations recognise that there is a degree of duplication in office functions. But there isn’t overlap in frontline clinical services.

“The NOC has a proud record and we will be looking to develop its services in the future.”

Ian McKendrick, secretary of Oxfordshire’s health branch of Unison, said the union would be closely monitoring the implica tions for jobs.

He said: “We are already seeing job freezes at the ORH and staff are having to carry the workload of those who have left. If there is to be rationalisation, it would make sense to look at management level, where substantial savings could be made.

“You would not need two chief executives, for example. You would not need two boards.”

The Government wants to see all hospital trusts become foundation trusts by 2014, with stringent standards and financial stability required. The proposed reorganisation is expected to significantly ease the way for Oxford hospitals to achieve this.

The NOC is one of only a handful of specialist hospitals nationwide to receive patients from across the UK and abroad with complex bone conditions.

But a change in the funding system for specialist services plunged the NOC into serious financial problems four years ago.

It now looks like being hit through fewer services being purchased for local patients by the county’s primary care trusts because of the wider financial crisis and a likely cap on the amount the NOC can charge for its specialist services.