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NHS cuts 'planned across England' NHS cuts 'planned across England'
(35 minutes later)
Plans are being drawn up that could see cuts to NHS services across England.Plans are being drawn up that could see cuts to NHS services across England.
The BBC has seen draft sustainability and transformation plans (STPs) which propose cuts in bed numbers, changes to A&E and GP care, a hospital closure and five ward closures in 44 areas. The BBC has seen draft sustainability and transformation plans (STPs) which propose cuts in bed numbers, changes to A&E and GP care and five ward closures in 44 areas.
There have been have been no consultations on the plans so far.There have been have been no consultations on the plans so far.
NHS England, which needs to find £22bn in efficiency savings by 2020-21, said reorganising local services is essential to improve patient care.NHS England, which needs to find £22bn in efficiency savings by 2020-21, said reorganising local services is essential to improve patient care.
But the Nuffield Trust think tank said while STPs could lead to "fundamental changes", many of the plans do not meet the financial targets set by the government and will face a "dauntingly large implementation task".But the Nuffield Trust think tank said while STPs could lead to "fundamental changes", many of the plans do not meet the financial targets set by the government and will face a "dauntingly large implementation task".
In a blog published on the Nuffield Trust website, its head, Nigel Edwards, said: "The speed of the process to shape these plans has meant that they have so far not been very visible". Laura Townshend, director of the campaign group 38 Degrees, said the plans had received very little public or political scrutiny.
The STPs are being drawn up by local health and social care leaders. She told BBC Radio 4's Today programme: "A key concern is why it hasn't been this transparent up until now.
"These plans are due to be signed off this October - a matter of weeks away".
'We need more courage'
The STPs are being drawn up by local health and social care leaders but many remain unpublished.
They were asked to find potential savings and efficiencies at the end of last year to meet financial targets set out by the former Chancellor George Osborne and NHS England head Simon Stevens.They were asked to find potential savings and efficiencies at the end of last year to meet financial targets set out by the former Chancellor George Osborne and NHS England head Simon Stevens.
Despite being due for sign off in October, many STPs are still unpublished. Stephen Dalton, Chief Executive of the NHS Confederation, said that the NHS would not "indiscriminately close services".
They are likely to be implemented in the new year. He said local discussions were "better than having a single plan" for the whole country.
Mr Dalton told the Today programme that in the past there has been reluctance from political leaders to address the way things are organised in the NHS.
He said much of the structure is "an accident of history", arguing that MPs have been dodging issues for too long.
'More inconvenienced''More inconvenienced'
The campaign group 38 Degrees uncovered many unreported draft STPs, including plans for the closure of Midland Metropolitan Hospital's accident and emergency department, the merging of two of the area's three district general hospitals and the closure of one site. 38 Degrees uncovered many unreported draft STPs, including plans for the closure of Midland Metropolitan Hospital's accident and emergency department, the merging of two of the area's three district general hospitals and the closure of one site.
In Leicester, Leicestershire and Rutland, there are plans to reduce the number of hospitals in the area from three to two. In the area of Leicester, Leicestershire and Rutland, there are plans to merge services reducing three acute hospital sites to two.
There are also plans to put GP surgeries under "review" because of a shortage of funding.There are also plans to put GP surgeries under "review" because of a shortage of funding.
A draft plan circulating among NHS managers in West Yorkshire reveals proposals to close the equivalent of five wards in the Leeds Teaching Hospitals Trust.A draft plan circulating among NHS managers in West Yorkshire reveals proposals to close the equivalent of five wards in the Leeds Teaching Hospitals Trust.
A spokeswoman for the area said: "We will be engaging and consulting as and when appropriate."A spokeswoman for the area said: "We will be engaging and consulting as and when appropriate."
In a blog published on the Nuffield Trust website, its head, Nigel Edwards, said: "The speed of the process to shape these plans has meant that they have so far not been very visible".
Mr Edwards said in some cases large numbers of patients would have to be shifted into community settings to make room for growing demand, while in others up to 20% of beds may be closed.Mr Edwards said in some cases large numbers of patients would have to be shifted into community settings to make room for growing demand, while in others up to 20% of beds may be closed.
The role of community hospitals is being questioned and the number of mental health inpatient sites could be reduced, he added.The role of community hospitals is being questioned and the number of mental health inpatient sites could be reduced, he added.
Sally Gainsbury, senior policy analyst with the trust, said: "It looks like quite a lot of these plans at the moment are proposing big, large-scale reconfigurations - that's shifting services or shutting services down. Sally Gainsbury, senior policy analyst with the trust, said many of the plans at the moment appeared to be proposing shifting or shutting services.
"Our research finds that, in a lot of these kinds of reconfigurations, you don't save very much money - all that happens is the patient has to go to the next hospital down the road."Our research finds that, in a lot of these kinds of reconfigurations, you don't save very much money - all that happens is the patient has to go to the next hospital down the road.
"They're more inconvenienced, they have to travel further, but it rarely saves the money that's needed." "They're more inconvenienced... but it rarely saves the money that's needed."
'Transformation''Transformation'
A NHS England spokesman said: "This is a unique exercise in collaboration. It is hardly a secret that the NHS is looking to make major efficiencies and the best way of doing so is for local doctors, hospitals and councils to work together to decide the way forward in consultation with local communities.A NHS England spokesman said: "This is a unique exercise in collaboration. It is hardly a secret that the NHS is looking to make major efficiencies and the best way of doing so is for local doctors, hospitals and councils to work together to decide the way forward in consultation with local communities.
"Proposals are at a draft stage but we expect all local leaders to be talking to the public and stakeholders regularly - it is vital that people are able to shape the future of their local services."Proposals are at a draft stage but we expect all local leaders to be talking to the public and stakeholders regularly - it is vital that people are able to shape the future of their local services.
"No changes to the services people currently receive will be made without local engagement and, where required, consultation. There are longstanding assurance processes in place to make sure this happens." "No changes to the services people currently receive will be made without local engagement and, where required, consultation."
38 Degrees director Laura Townshend said: "This is new evidence that plans are being made to close local NHS services. David Pearson, STP leader for Nottinghamshire, told BBC Radio 4's You and Yours programme: "Sometimes, we have particular conditions or particular treatments that are best in a centre of excellence...
"We all rely on these services, yet we are being kept in the dark.
"These proposed cuts aren't the fault of local NHS leaders.
"The health service is struggling to cope with growing black holes in NHS funding.
"The NHS belongs to all of us - so local people should get a say in any changes to their local services."
David Pearson, STP leader for Nottinghamshire, told BBC Radio 4's You and Yours programme: "Sometimes, we have particular conditions or particular treatments that are best in a centre of excellence.
"So, that's part of the debate we will no doubt have.
"But this is fundamentally about making sure we are doing the best things across Nottinghamshire and that, as far as possible, services are locally delivered to an agreed understanding of what best practice is."But this is fundamentally about making sure we are doing the best things across Nottinghamshire and that, as far as possible, services are locally delivered to an agreed understanding of what best practice is.
"The transformation of services is rarely just one big dramatic closure. "The transformation of services is rarely just one big dramatic closure."
"It's thousands of people working with citizens to deliver the best possible outcomes, and that's what this is about."
Do you work in the NHS? Are you aware of how your services may be affected by upcoming efficiency savings? You can email us at haveyoursay@bbc.co.uk.Do you work in the NHS? Are you aware of how your services may be affected by upcoming efficiency savings? You can email us at haveyoursay@bbc.co.uk.
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Do you work in the NHS? Are you aware of how your services may be affected by upcoming efficiency savings? You can email us at haveyoursay@bbc.co.uk. Please include a telephone number if you are happy to speak to a BBC journalist.
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