Norfolk and Suffolk's mental health trusts have cleared a vital hurdle in their journey to merge, because there are 'pressing clinical quality and safety issues' with Suffolk's service.

The merger has been given approval by Monitor, the independent regulator of NHS foundation trusts, despite concerns that it could create an organisation which would stifle patient choice and competition.

However, in a bid to address the concerns raised by the Cooperation and Competition Panel (CCP), which recommended the merger does not go ahead, Monitor has decided to impose conditions around transparency, information publication and a commitment for retendering of services on Norfolk and Waveney Mental Health NHS Foundation Trust's acquisition of Suffolk Mental Health NHS Trust.

Dr David Bennett, chairman of Monitor's board, said: 'We've made this decision based on evidence that there are pressing clinical quality and safety issues at Suffolk Mental Health Trust. The board, therefore, decided that it would be in patients' interests if the acquisition were to go ahead so that these issues can be addressed quickly and effectively.

'However, in order to protect patients' broader interests, Monitor will also require a range of remedies to be put in place. These remedies will seek to make sure pressures are maintained on the new, combined organisation to continue to improve the quality of care patients receive.'

Earlier this year an independent report highlighted the failings of Suffolk's mental health service. The review was commissioned following a series of unrelated deaths, which are still the subject of individual investigations.

Monitor has also criticised the decision to place members of Norfolk and Waveney's management team in temporary charge of Suffolk Mental Health Trust before the official merger had been approved.

Dr Bennett said: 'I want to be very clear that parties involved in a proposed acquisition should in future submit all relevant evidence to the CCP at the time of its review and that they must not proceed with any part of the acquisition before Monitor has made its decision. This process is in place to ensure that patients are protected. It isn't fair that the taxpayer should have to foot the bill if parties are made to unwind arrangements they have put in place prematurely. Second guessing the results of the process is bad for both patients and taxpayers.'

Norfolk mental health trust chief executive Aidan Thomas said: 'We believe that the merger is of real benefit to patients and taxpayers in Norfolk and Suffolk, and we're pleased that Monitor found that the merger would be in patients' interests, especially in terms of quality and safety.'

He added: 'The trust will now consider the remedies put forward by Monitor and will make a decision as a board in late October.

'In the meantime the trust is pleased to say the merger looks likely as the trust continues to work with Monitor on the remedies.

'We look forward to a positive outcome from any further discussions.'

Earlier this year the trusts said that the plan was to merge from July 1 this year at the earliest, however it is not known how soon this can be achieved as the approval from Monitor was delayed by several months.

The potential savings of the merger are estimated at �5.1m over the next three years, most of which are planned to be made through changes to corporate and support services, rather than frontline staff, with 80 posts expected be affected.