NHS crisis: 19 hospitals face axe as doctors accuse Government of deliberate underfunding

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The NHS in Warwickshire is facing its biggest shake-up in a generation with care from cradle to grave put through a wholesale overhaul to slash £300million from the health service budget in the region.

As part of a national shake-up designed to fill an estimated £22bn financial black hole by April 2021, proposals have been unveiled for this area that will see the closure of the A&E department at George Eliot Hospital in Nuneaton and the moving of the maternity and children’s care from George Eliot Hospital to University Hospital in Coventry.

The STP plans also revealed that the stroke care, which is currently at Warwick Hospital and at George Eliot Hospital will all be moved to the Coventry Hospital.

Analysis by this newspaper and our sister titles in Johnston Press of the 44 regional blueprints drawn up by health service leaders to remodel the NHS - a process which critics complain has largely bypassed clinicians and patients - has revealed the extent of the cuts and drastic changes in the delivery of care that the Government wants to achieve by April 2021.

Until their recent release, the plans were a closely guarded secret with health chief instructing managers to keep draft details out of the public domain and turn down freedom of information requests to prevent “politically sensitive” changes from leaking out.

The final documents are in some cases so riddled with jargon and vague assertions that clinicians and politicians have said the impact of the plans is unknown.

But an in-depth review of the proposals by the Johnston Press Investigation Unit, in consultation with professional bodies, shows the far-reaching nature of the changes which supporters say are necessary to produce a viable NHS and opponents warn amount to a charter for creeping privatisation and the end of the founding ideals of the health service.

Our national findings include:

*The proposed or likely closure of 17 hospitals, including four major acute hospitals.

*The closure of more than 2,000 beds in acute and community hospitals and the loss of nearly 3,000 jobs to create a “smaller, more agile” workforce.

*Major re-organisations of emergency and maternity care with dozens of units facing closure or downgrading. One in six A&Es are under threat.

*The size of deficit per head of population varies dramatically across England. In the Durham, Darlington and Tees area the amount that needs to be cut is £216 per capita but in Surrey Heartlands the amount is more than triple at £768.

*24,000 unfilled nursing vacancies across the country and fears lower-qualified staff will be used to fill the void

*A massive move to “out-of-hospital” care with patients encouraged to manage their own health needs using technology. Primary care “hubs” will bring health services closer to home - in one case potentially using libraries to see patients.

*Hundreds of millions of pounds are to be saved by cutting prescription costs and in some cases rationing care or operations. In north east London, managers are considering a rule that specialist beds are restricted to those who require a minimum stay of 48 hours.

*A drastic reduction in face-to-face outpatient appointments with doctors using video links to assess and discharge patients.

Known as Sustainability and Transformation Plans (STPs), the plans represent the fruit of more than a year of consultations between more 440 NHS organisations and 152 local authorities.

But despite a timetable that is due to see them finalised by later this year, with far-reaching consequences for some 55 million people, the STPs are almost unknown to the public.

One survey last month found that six out of seven people have not heard of the plans, prompting warnings to that the shake up is being pushed through without meaningful consultation or consent.

Concerns about the Coventry and Warwickshire STP plan have been voiced by the Warwick District and Rugby Borough Councils and by Warwickshire County Council.

Warwick District councillor Moira-Ann Grainger (Con, Woodloes), put forward a motion to the District Council asking members to agree that the authority should not sign-up to the STP until “there has been full public engagement”, “it has been co-produced along with the Health and Wellbeing Boards of both Warwickshire County Council and Coventry City Council” and “it is rewritten in language which is accessible to the public”.

The motion was supported and a similar motion was also put forward and supported by the Rugby borough council

The county council said that it will not sign up to the STP unless there has been full public engagement, until it has been co-produced along with the health and wellbeing boards of both the county council and Coventry City Council and unless it is re-written in language which is accessible to the public.

Coventry and Warwickshire STP have been approached for a comment regarding the lack of support from local and county councils.

The proposals to balance the books of a health service struggling to cope with burgeoning demand amid claims of deliberate underfunding yesterday brought accusations from doctors’ leaders that they amount to a “clever ploy” to hollow out the NHS while shifting blame away from ministers onto the health service chiefs in charge of the overhaul.

Dr Mark Porter, chairman of the British Medical Association, which represents more than 150,000 doctors, told us: “We are being asked for too much and are being deliberately underfunded. What this means is our inability to deliver on our promise to patients of a comprehensive service that meets the needs of everyone, when they need it, free of charge.

“We have increased numbers of patients while resources are not rising in the same way. They are deliberately cutting into the service we provide rather than streamlining services. What is being asked goes far beyond efficiency savings and dips into the area of cuts.”

But the plans to change to a health service focused on preventing serious illness and moving care into the community while centralising services in acute hospitals have also received backing from clinicians and policy makers. The left-leaning IPPR think-tank said many of the NHS reforms “deserve a fair hearing”.

A Department of Health spokesperson said: “We are committed to the NHS — that’s why we have invested £10 billion in its own plan to transform services and improve standards of care, including almost £4 billion this year.

“NHS England are introducing Sustainability and Transformation Plans to help ensure the best standards of care, with local doctors, hospitals and councils working together in conjunction with local communities for the first time.”