Plan for future of NHS '˜could be used as cover for delivering cuts'

Health managers in 44 areas of England have been ordered to draw up the strategies, setting out how they will reduce costs, change services and improve care in the wake of a record £2.45bn deficit for the last financial year.

The BMA’s head, Dr Mark Porter, said there was a danger of the plans being “used as a cover for delivering cuts, starving services of resource and patients of vital care”.

The sustainability and transformation plans (STPs), some of which have been published or leaked, could see some hospitals, A&E units or maternity units close, and other services merged.

Dr Porter, the chairman of the BMA’s council, said: “Improving patient care must be the number one priority for these plans. Given the scale of the savings required in each area, there is a real risk that these transformation plans will be used as a cover for delivering cuts, starving services of resource and patients of vital care.

“It is extremely concerning that the majority of doctors have not been consulted on the plans, particularly as Ministers have been so keen to insist that all stakeholders would be involved.

“STPs have the potential to generate more collaboration and the longer-term planning of services based on local need. But it is crucial that any plans about the future of the NHS must be drawn up in an open and transparent way, and have the support and involvement of clinicians, patients and the public from the outset. At this stage nobody can be confident that this has happened.”`

A STP is being published today by Humber Coast and Vale, which covers six clinical commissioning groups and takes in York, Scarborough and Ryedale, as well as Hull, East Riding and northern Lincolnshire.

The reorganisation, to tackle a £420m funding gap by 2020/2021, includes a review of services including paediatrics, neonatal intensive care and specialised orthopaedics. Support services including finance, as well as pathology and pharmacy, could be shared to “reduce cost and improve efficiency”. The STP also seeks to address “inequalities in health” in the area and proposes investment to improve access to GPs and modernise surgeries.

The Yorkshire Post revealed on Saturday that health chiefs had been warned the elderly and vulnerable living in Yorkshire’s isolated communities will be at grave risk under a controversial re-organisation of the NHS, North Yorkshire County Council’s influential health scrutiny committee claimed the STPs were modelled around the needs of urban areas, threatening to leach health funds from rural districts.

The new analysis by the BMA is based on savings figures found in documents from 42 of the 44 areas. An accompanying survey of 310 doctors in England found 64 per cent had not been consulted on STPs. A third of doctors had never heard of STPs and a fifth did not support their introduction, the BMA poll found.

NHS England has argued that STPs will improve patient care and are necessary to fulfil Health Secretary Jeremy Hunt’s plan for full seven-day services.

The NHS’s Medical Director, Professor Sir Bruce Keogh, said: “We are talking about steady incremental improvement, not a big bang, tackling things doctors and nurses have been telling us for years. By continuing to adapt to a changing world, the NHS will be able to secure a better service for future generations.”