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Politicians must not 'collude' to stop closures of unsafe hospital services

Too many hospital services are “unsafe” and politicians must not “collude” to keep them open because they fear controversy over closures, a leading think tank has said.

NHS authorities are drawing up radical plans to reorganise services in a bid to save £22bn and cope with rising demand from an ageing population.

Draft plans suggest this could result in the closure of 24 Accident & Emergency departments, with swingeing bed cuts.

The King’s Fund today urged politicians to back radical changes as “the best hope” of achieving essential reforms. But it also urged NHS leaders to rewrite many of the proposals - saying it was “simply not credible” to scale back bed numbers when wards have been stretched to the limit this winter.

NHS budget 

It came as new figures showed NHS trusts racked up a deficit of nearly £900m in the first nine months of the 2016/17 financial year.

Even that was only achieved because of a £1.8bn fund put aside to help hospitals tackle their financial problems, leaving an underlying deficit of close to £3bn, experts said.

On Monday a report revealed that the NHS has seen the loss of 15,000 beds in just six years, with around one in ten closed.

Several of the plans have already triggered protests. Councils in north-west London have objected to plans which could see the number of major hospitals cut from nine to five.  

Across Dorset, hospital beds will be cut from 1,810 to 1,570 with the centralisation of A&E services at Royal Bournemouth Hospital, under proposals. In Leicestershire and Rutland, the plan is to cut the number of hospitals from three to two, and cut acute hospital beds from 1,940 to 1,697. And plans for south-west London aim to achieve a 44 per cent reduction in inpatient bed days, with a 13 per cent dropped in planned operations.

Derbyshire plans to slash 400 acute hospital beds, while 200 beds are earmarked for closure at Nottingham University Hospitals NHS Trust.

In numbers | NHS deficits in England

In other areas, services will be centralised or merged, such as in Cambridgeshire and Peterborough where orthopaedics, stroke, maternity and paediatrics could be centralised.

The think tank said the plans were “an opportunity to move care closer to home and moderate demand for hospital services.”

But it said improvements would not be made unless investment was made first in services in the community.

Chris Ham, chief executive of the think tank, said many hospitals were at “the limits” of their capacity.

"We do not think now is the time to start cutting back on acute hospital beds and capacity, anything like on the scale set out in some of the plans,” he said.

Axing hundreds of beds was "simply not credible given the state of our acute hospitals this winter, which is likely to be similar next winter."

In the weeks running up to Christmas, more than a dozen hospitals across Englan were running at 100 per cent capacity, with latest figures showing average occupancy is still over 95 per cent.

Last week a coroner wrote to the head of the NHS, after a woman died from a brain haemorrhage after at least three hospitals refused to admit her for surgery because they had no intensive care beds.

Mr Ham said the NHS needed to embark on “difficult conversations with the public” about how changes should be achieved.

Why is the NHS under so much pressure?

And he urged politicians to support changes as long as there was a clear evidence base for them.

A failure to do could leave patients to suffer at the hands of poor services, he said.

"If you're not willing to do go through that process and support plans of this kind, essentially you are colluding as politicians in the continuation of unsafe services,” he said.

Draft plans have been submitted from 44 areas of the country, and are now being considered by health service officials.

Major changes to services – such as the loss of an Accident & Emergency unit or maternity ward  will require public consultation.