Plans To Centralise NHS Treatments Could Cost Lives

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In radical plans to shake-up the NHS, namely in an attempt to plug the £22billion spending hole thought to be facing health budgets by 2020, local services could be cut to centralise treatment at larger hospitals across the country.

Plans to overhaul NHS services could risk patient safety

It is claimed that the plans could cause thousands of beds to be cut as smaller services are closed or downgraded in favour of centralised units with a specific focus.

Responding to the plans, Kay Barnes – former-midwife and Senior Solicitor on Simpson Millar's Medical Negligence team – explains how the planned closures could affect patients.

Sustainability & Transformation Plans (STPs)

The plans have been uncovered by the Times after they reviewed 44 published Sustainability & Transformation Plans (STPs). STPs are published by health and care systems across England to try and show how local services will change – and become more sustainable – over a set number of years.

STPs were introduced as a way to deal with funding deficiencies within the NHS.

Most of the plans look to improve and increase GP surgeries, in an attempt to keep older and frailer patients out of hospital, unless their admission is medically necessary.

An increase in spending on GP surgeries should give patients a greater chance of receiving the treatment they need at a primary care level; however it comes alongside the news that local A&E departments, maternity units, and local hospitals will be closed to make way in favour of larger centralised hospitals and healthcare centres.

It is feared that:

  • 19 A&E departments are under threat of closure
  • A dozen maternity units could be closed in favour for a larger centralised service
  • 1,800 beds and 10 local hospitals are being considered for closure, as local health chiefs claim they cannot afford to keep smaller services


While the proposals outlined in the STPs analysed by The Times are yet to be implemented, it is feared that their roll-out could place patients at a significant risk of harm.

Danger To Patients

The cutting of thousands of beds will be mainly taken from local hospitals and medical centres as treatments for heart surgery and cancer care will be centralised in larger locations across the country.

Maternity units will also be hit if the proposals go ahead, with consultant-led labour wards making way for midwife-led birthing centres, a move that aims to free up doctors for larger hospitals that deal solely with complications during childbirth.

It is this move that is causing particular concern, as the health and safety of both mother and child could be compromised by a system that could see mothers moved during labour after complications arise.

Current figures show that one in four women who give birth at midwife-led units have to be transferred to hospital, leading to a high risk of neonatal deaths as women have to travel long distances if they develop complications during labour.

Responding to the proposals, Kay said:

"Plans to close or downgrade dozens of A&E departments, maternity units and local hospitals under radical NHS plans are worrying, especially in an overburdened service already suffering from significant cuts to public health budgets."

"Even more concerning are plans to replace consultant-led labour wards with more midwife-led units, even though figures show that one in four women are already transferred to hospital when complications arise that warrant obstetric input."

"As a senior Medical Negligence solicitor and former midwife I echo the concerns of Mark Porter, head of the British Medical Association, who said that patients will be horrified about these closures, especially as these plans are being drawn up behind closed doors without proper public and clinical involvement from the start."

"Many patients will be affected and will be horrified at the prospects of planned closures. All areas of patient care are important but with maternity services, this will leave many women with long distances to travel to get the care they need."

"In cases where transfer to a consultant led unit is necessary, minutes may well make all the difference and will make for an extremely anxious journey. The lives of both baby and mother will be at added risk with the possibility of tragic outcomes."

"That plans have been drawn up without proper public and clinical involvement is even more worrying. It is hoped that provision of vital care is maintained and that patients are not exposed to greater risk in attempts keep costs within an increasingly tight budget."


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