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Hospital cuts planned in most of England Hospital cuts planned in most of England
(about 4 hours later)
Plans have been put forward to cut hospital services in two-thirds of England, a BBC analysis shows.Plans have been put forward to cut hospital services in two-thirds of England, a BBC analysis shows.
The proposals have been put forward by local NHS bosses as part of a national programme to transform the health service and save money. The proposals have been made by local NHS bosses as part of a national programme to transform the health service and save money.
They include everything from full closures of hospitals to cutting some specialist services such as accident and emergency and stroke care.They include everything from full closures of hospitals to cutting some specialist services such as accident and emergency and stroke care.
Ministers argue patients will receive better care in the community.Ministers argue patients will receive better care in the community.
But a review of the plans by the King's Fund think tank warned they were not always credible because there were not enough services outside of hospitals. Alongside cuts to hospital care, the proposals also set out visions for better care outside of hospitals, including:
It warned GPs, district nursing and council care services were already "feeling the strain" and could not currently cope with an increase in workload. But a review of the plans by the King's Fund think tank warned they were not always credible because there were not enough services outside of hospitals and there was a lack of money to invest in more.
It warned community services were already "feeling the strain" and could not currently cope with an increase in workload.
And the King's Fund said further reductions in the number of hospital beds could de-stabilise services that were already "stretched to their limits" following the difficult winter.And the King's Fund said further reductions in the number of hospital beds could de-stabilise services that were already "stretched to their limits" following the difficult winter.
Need help finding out which region you are in? See the map at the foot of the page.Need help finding out which region you are in? See the map at the foot of the page.
In total, 44 local plans have been drawn up across England.In total, 44 local plans have been drawn up across England.
The BBC has analysed each one and has identified 28 that mention some form of cut to local hospitals.The BBC has analysed each one and has identified 28 that mention some form of cut to local hospitals.
These include:These include:
The plans - known as sustainability and transformation plans - have been drawn up as part of NHS England's five-year strategy to release £22bn of efficiency savings by 2020. The proposals - known as sustainability and transformation plans - have been drawn up as part of NHS England's five-year strategy to release £22bn of efficiency savings by 2020.
Reviews were set up in early 2016 and consultations on major changes will take place later this year with the hope implementation will follow soon after.Reviews were set up in early 2016 and consultations on major changes will take place later this year with the hope implementation will follow soon after.
But the King's Fund warned the changes could be subject to legal challenges.But the King's Fund warned the changes could be subject to legal challenges.
How closing hospital services can be good thing
Stroke care in London is now world class - and it is all because some services were shut down.
The capital's stroke care was overhauled in early 2010. Instead of being spread across 30 hospitals as they used to be, services are now centralised on eight "super sites".
It has meant patients get fast, 24-hour access to the best care, saving hundreds of lives a year.
If a stroke is suspected, a patient is immediately taken to one of the eight centres. There they are assessed by a stroke specialist and given a brain scan within 30 minutes of arrival.
However, Prof Chris Ham, the think tank's chief executive, said they were still the "best hope of delivering essential reforms" in the NHS, as care needed to be moved out of hospital.However, Prof Chris Ham, the think tank's chief executive, said they were still the "best hope of delivering essential reforms" in the NHS, as care needed to be moved out of hospital.
This is seen as vital because the ageing population and growth in long-term conditions such as dementia and heart disease mean people are more likely to benefit from support in the community to stay well rather than inpatient hospital care when their health deteriorates.This is seen as vital because the ageing population and growth in long-term conditions such as dementia and heart disease mean people are more likely to benefit from support in the community to stay well rather than inpatient hospital care when their health deteriorates.
'Sustainable change'
But Prof Ham said this could not be done without extra funding - and urged the government to find the money to invest in the services to enable transformation to happen.But Prof Ham said this could not be done without extra funding - and urged the government to find the money to invest in the services to enable transformation to happen.
A £1.8bn pot set aside this year for funding transformation had already been swallowed up by deficits, figures released on Monday showed.A £1.8bn pot set aside this year for funding transformation had already been swallowed up by deficits, figures released on Monday showed.
"Local plans must be considered on their merits, but where a convincing case for change has been made, ministers and local politicians should back NHS leaders," Prof Ham said."Local plans must be considered on their merits, but where a convincing case for change has been made, ministers and local politicians should back NHS leaders," Prof Ham said.
A Department of Health spokesman said extra money was being invested in the NHS this Parliament.A Department of Health spokesman said extra money was being invested in the NHS this Parliament.
"These NHS plans - developed by local doctors, hospitals and councils working together with the communities they serve - will help patients get better care," he added."These NHS plans - developed by local doctors, hospitals and councils working together with the communities they serve - will help patients get better care," he added.
A spokeswoman for NHS England said current plans offered the best hope of improving patient care in a sustainable way.
"They will allow the NHS to take advantage of new technologies, adopt successful practice more widely, and make practical improvements in areas that we know matter most to patients," she added.
"These proposals are all about putting collaboration at the heart of our care system, with health and local government working more closely together than at any time since the NHS was created. Everyone in the NHS wants help to ensure we can all get excellent care whenever we need it."
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1. Northumberland, Tyne and Wear1. Northumberland, Tyne and Wear
2. West, North and East Cumbria2. West, North and East Cumbria
3. Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby3. Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby
4. Lancashire and South Cumbria4. Lancashire and South Cumbria
5. West Yorkshire5. West Yorkshire
6. Coast, Humber and Vale6. Coast, Humber and Vale
7. Greater Manchester7. Greater Manchester
8. Cheshire and Merseyside8. Cheshire and Merseyside
9. South Yorkshire and Bassetlaw9. South Yorkshire and Bassetlaw
10. Staffordshire10. Staffordshire
11. Shropshire and Telford and Wrekin11. Shropshire and Telford and Wrekin
12. Derbyshire12. Derbyshire
13. Lincolnshire13. Lincolnshire
14. Nottinghamshire14. Nottinghamshire
15. Leicester, Leicestershire and Rutland15. Leicester, Leicestershire and Rutland
16. The Black Country16. The Black Country
17. Birmingham and Solihull17. Birmingham and Solihull
18. Coventry and Warwickshire18. Coventry and Warwickshire
19. Herefordshire and Worcestershire19. Herefordshire and Worcestershire
20. Northamptonshire20. Northamptonshire
21. Cambridgeshire and Peterborough21. Cambridgeshire and Peterborough
22. Norfolk and Waveney22. Norfolk and Waveney
23. Suffolk and North East Essex23. Suffolk and North East Essex
24. Milton Keynes, Bedfordshire and Luton24. Milton Keynes, Bedfordshire and Luton
25. Hertfordshire and West Essex25. Hertfordshire and West Essex
26. Mid and South Essex26. Mid and South Essex
27. North West London27. North West London
28. North Central London28. North Central London
29. North East London29. North East London
30. South East London30. South East London
31. South West London31. South West London
32. Kent and Medway32. Kent and Medway
33. Sussex and East Surrey33. Sussex and East Surrey
34. Frimley Health34. Frimley Health
35. Surrey Heartlands35. Surrey Heartlands
36. Cornwall and the Isles of Scilly36. Cornwall and the Isles of Scilly
37. Devon37. Devon
38. Somerset38. Somerset
39. Bristol, North Somerset and South Gloucestershire39. Bristol, North Somerset and South Gloucestershire
40. Bath, Swindon and Wiltshire40. Bath, Swindon and Wiltshire
41. Dorset41. Dorset
42. Hampshire and the Isle of Wight42. Hampshire and the Isle of Wight
43. Gloucestershire43. Gloucestershire
44. Buckinghamshire, Oxfordshire and Berkshire West44. Buckinghamshire, Oxfordshire and Berkshire West