NHS cuts being kept under wraps, King’s Fund investigation says

An investigation by the King’s Fund has highlighted that local NHS mangers have been told to keep full details of reviews to services around the country ‘out of the public domain’.

The think tank has warned that taking this approach means the views of the public and frontline staff have more or less been absent in the process so far.

While the report did not include any details of cuts, leaked plans have painted a picture of what we can expect so far: plans in south west London to close one of five hospitals - St George's, Kingston, Croydon, St Helier or Epsom; the North Tees proposal to centralise specialist services, including A&E, on two sites. It would lead to services being downgraded at one of the three major hospitals in the area; and in Devon bosses are looking at whether to close some A&E, maternity and strike services at hospitals across the county so they can be centralised at bigger sites

Furthermore, in Merseyside there has been talk of merging four hospitals - the Royal Liverpool, Broadgreen, Aintree and Liverpool Women's - to plug a £1 billion shortfall; plans in Birmingham and Solihull involve reorganising maternity services with fears this could result in fewer units; and bosses at North Central London have talked about a consolidation of services on fewer sites, leading to fears that the Whittington Hospital could lose its A&E.

The investigation included interviews with staff involved in four sustainability and transformation plans (STPs), carried out on an anonymised basis. The local managers claimed they had been directed to keep the process ‘private and confidential’, with many raising concern over the lack of public involvement.

It concluded that there were ‘clear anxieties’ among ministers and NHS leaders over the way the plans could be interpreted by the public.

Prof Sir Bruce Keogh, NHS England's medical director, said: “I am sure there are things that could be learnt about the process. But when you are trying to improve care across a whole system, things are never going to be straightforward.”

Meanwhile, Jeremy Taylor, of National Voices, which represents patients, argued: "Developing plans behind closed doors, and presenting near-final proposals, does not count as meaningful involvement."