NHS transformation plans may be used as cover for cuts, says BMA

Controversial plans put forward as a way of improving the health service in England and ensuring its sustainability risk being used as a cover for cuts and running down the NHS, the head of the British Medical Association (BMA) has said.

The doctors’ union says the 44 regional sustainability and transformation plans (STPs) amount to £22bn in cuts by 2020-21 to balance the books, which will have a severe impact on patient care.

Guardian analysis of the plans that have been published has found that thousands of hospital beds are set to disappear, pregnant women will face long trips to give birth and a string of A&E units will be downgraded or closed.

Dr Mark Porter, the BMA council chair, 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.”

NHS England is expected to find £22bn in efficiency savings by 2020-21 but its finance directors and independent experts have suggested the target is unattainable, as the health service struggles with unprecedented demand and understaffing.

NHS England describes the STPs as intended to “drive genuine and sustainable transformation in patient experience and health outcomes of the longer term”.

The BMA says the plans have a potentially positive role to play if they help develop health policies more suited to local needs and integrate services across health and social care. It fears, however, that they are being driven by other priorities and claims there has been a lack of consultation.

A survey of 310 BMA members found around two-thirds said they had not been consulted and a third had never heard of the STPs. Only 14% firmly supported their introduction with 64% undecided and the rest against.

Porter said: “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.”

Among the acute service beds at general hospitals set to be cut are 535 in Derbyshire, 400 each in Devon and West Yorkshire and 30% of all beds in hospitals in Bristol, North Somerset and South Gloucestershire.

The BMA says the STPs should be funded appropriately so that they can deliver what has been promised, rather than being used to cut back services.

The shadow health secretary, Jonathan Ashworth, said: “These warnings that the proposed changes to local services in STPs are overwhelmingly driven by cuts – £22bn of them – will set alarm bells ringing and rightly so. It’s amazing that the government can claim that these plans are clinically driven when two-thirds of doctors say they haven’t even been consulted.

“What’s been revealed so far are drastic proposals to cut beds and services. It’s simply not acceptable for these decisions to made behind closed doors.”

The NHS medical director, Prof Sir Bruce Keogh, said the NHS was constantly adapting to improve services, “making commonsense changes in areas that really matter to patients”.

“We are talking about steady incremental improvement, not a big bang, tackling things doctors and nurses have been telling us for years,” he said. “By continuing to adapt to a changing world, the NHS will be able to secure a better service for future generations.”

NHS transformation plans may be used as cover for cuts, says BMA