NHS plans to close hospitals and A&E departments kept secret from the public, investigation finds

Health managers have been told not to reveal the plans to the public or the media

Local A&E departments could be at risk (Charlie Forgham Bailey)

NHS bosses are keeping cost-cutting plans that could lead to hospital and A&E closures secret from the communities they will affect, an investigation has found.

Health managers in 44 areas of England have been ordered to draw up strategies setting out how they will reduce costs, change services and improve care in the wake of a record £2.45 billion deficit.

But they have been told not to reveal the plans to the public or the media until they are finalised and have been approved by their own officials first.

A report from leading think tank the King’s Fund warned that patients and the public were “largely absent” from the development of the plans, which could see sweeping closures of health services affecting millions of people.

“All the national guidance says don’t share it, don’t put in the public [domain]," said one local health leader interviewed by the King’s Fund.

The government wants to “manage the national political messages to make sure that things like hospital closures and things like that don’t get leaked,” they said.

The ‘sustainability and transformation plans’ (STPs) could see some hospitals, A&E units or maternity units close, and other services merged.

NHS England has told local managers to refuse applications from the media or the public wanting to see the proposals under the Freedom of Information Act, according to the report.

The King's Fund said NHS England had set very tight timescales, which are partly to blame for why patients and doctors have been shut out.

“Leaders told us it was almost impossible to involve patients and the public effectively in the plans within the timescales available,” the report said. “As one leader told us, ‘it’s a complete no-hoper’.”

However, some of the plans have been published or leaked by those who disagree with the lack of public involvement.

Some councils have objected so strongly to the secrecy they have ignored NHS England's demand to keep the documents private until a later stage and have published them on their websites.

Earlier this month it was revealed that a number of Merseyside hospitals could be merged, A&E departments downgraded and Liverpool Women’s hospital relocated in an attempt to plug a £900m finance gap in the area.

In north west London, there are plans to reduce the number of sites offering a full range of services while Birmingham and Solihull's STP proposes a single “lead provider” for maternity care.

Some councils have objected so strongly to the secrecy they have ignored NHS England's demand to keep the documents private until a later stage and have published them on their websites.

NHS England and some health experts say the changes will improve patient care and are necessary to fulfil Health Secretary Jeremy Hunt's plan for full seven-day services, but campaigners argue they are just a way of cutting services.

Chris Ham, chief executive of the King's Fund, said it was a “heroic assumption” to say out-of-hospital services and GPs could take on more of the work currently done by hospitals, given how under pressure they were.

He criticised the lack of back-up plans to the proposals, but said STPs still offered the “best hope” of improving health and care services.

“The introduction of STPs has been beset by problems and has been frustrating for many of those involved, but it is vital that we stick with them,” he said.

“For all the difficulties over the last few months, their focus on organisations in each area working together is the right approach for improving care and meeting the needs of an ageing population.”