Are NHS transformation plans cuts in disguise?

The 44 regional and sustainability plans announced by NHS would see a cost saving in the region of £22bn by 2020-21. The British Medical Association (BMA) has stated that it views these changes as a way of reducing the public offering the NHS is able to provide by reducing the number of hospital beds and closures of A & E units.

The risk to patient care that these transformation plans or cuts will have is of paramount importance to the effective delivery of NHS care to the public. This issue has been raised by Dr Mark Potter, BMA Council Chair:- “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.”

There is a delicate balancing act to be drawn between efficiency savings and the point at which efficiencies begin to negatively impact the service offered to patients. The NHS suggests that the transformation plans are incremental and do not represent a root and branch change in the way that NHS services are delivered. Sir Bruce Keogh, NHS Medical Director said:  “We are talking about steady incremental improvement, not a big bang, tackling things doctors and nurses have been telling us for years. By continuing to adapt to a changing world, the NHS will be able to secure a better service for future generations.”

The scale and size of the NHS makes some of the numbers that are regularly quoted when speaking of the organisation seem incapable of being properly understood: it is clear that the NHS is planning to reduce it’s expenditure by almost 25% by 2020-21. It is inconceivable that a reduction on such a scale would only minimally impact the delivery of the service offered. Tough decisions will have to be made with regard to the cost benefit or detriment of particular courses of action. It is hoped however one interprets these plans that patient care is still given the priority it deserves.

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