SOUTH Cumbria has been named as one of 13 areas where NHS bosses have been accused of burying secret plans to make hundreds of millions of pounds worth of savings.

The British Medical Association has today released allegations that health leaders have refused to publish details of proposals made under the Capped Expenditure Process. The trade union for UK doctors and medical students claims hidden plans could contain cuts causing longer waiting times, reduced access to services, cut-backs on prescriptions and treatments and even the need to merge or close hospitals and facilities.

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The CEP was introduced in April, and instructs NHS commissioners and providers in 13 areas across England – those with the largest budget deficits – to make considerable cuts in order to achieve financial balance by April 1, 2018. The Morecambe Bay area incorporating Lancashire and south Cumbria has been named as one of the 13.

According to the BMA, the areas affected by the CEP are under intense pressure to drastically reduce spending by around £500m, and health leaders have been told to ‘think the unthinkable’ with regards to cuts.

BMA council deputy chairman, Dr David Wrigley, said: “These plans could have serious consequences for doctors working on the front line and for the care and treatment patients receive and can expect in hospitals and GP surgeries in these areas.

“This government must stop and think before pressing ahead, as cuts on this scale in this time-frame would have a devastating impact on patients and staff. Our NHS is one of the very best healthcare services in the world, with hugely talented staff, but it relies too much on the goodwill of the staff who dedicate their lives to helping patients.

“This simply cannot go on. The government must provide adequate funding for the health service before it is too late.”

Each area has submitted plans for spending cuts, and the BMA has sent Freedom of Information requests to all of them, as well as NHS Improvement, requesting the proposal documents. NHS Improvement said the documents belong to local health authorities and suggested requests were forwarded to those organisations.

The doctors’ union then wrote to organisations in each of the areas requesting the final return – or the details within if not the whole documents. It claims representatives from just eight of the 13 areas responded and none provided the full document or any significant details of their plan.

Dr Wrigley added: “It is bad enough that brutal cuts could threaten the services but it is totally unacceptable that proposals of this scale, which would affect large numbers of patients, are shrouded in such secrecy.

“Patients, the public and frontline staff – who have worked so hard to keep the health service afloat through years of underfunding in the face of rising demand – must be at the heart of any plans for the future of the health service but we are all frozen out of discussions, and local health managers are being asked to push forward despite being unwilling to share their decisions openly.”

The BMA said it is deeply concerned by the CEP, the secretive manner in which plans have been drawn up, and the risk that proposed cuts to already stretched services will have to patient care and NHS staff. Senior NHS leaders involved in drawing up local plans are said to have told the BMA that even the more modest of the proposals “would cause uproar”, and that they are frustrated by the ‘ridiculous’ pace and secrecy of the process. One said he felt local leaders were being bullied.

Speaking anonymously to the union, one trust chair with oversight of the process of drawing up the plans in his area, said: “We were descended on and asked to think the unthinkable in no time at all. The NHS seems to go into a zone of secrecy as an automatic reaction.

“That’s the thing that really upsets me – the secrecy of it all and the ridiculous pace in which solutions are to be crafted and agreed. It’s the management culture too – it’s all hierarchical power and bullying. Even the most modest proposals would cause uproar.”

The Mail has contacted the University Hospitals of Morecambe Bay NHS Foundation Trust and the Morecambe Bay Clinical Commissioning Group for comment.

The Capped Expenditure Process (CEP): What is it?

Providers of hospital, ambulance, community and mental health services are expecting to overspend their budgets by nearly £500 million this year, and funding growth in the NHS remains relatively slow. To respond to the resulting financial pressure, NHS England and NHS Improvement introduced tighter controls on NHS spending.

The CEP aims to contain or ‘cap’ spending in specific areas of the country, focusing on health care systems (including both commissioners and providers of health care), rather than individual organisations. It is targeted at commissioners and providers in selected areas of the country, said to have had he largest gap between their planned expenditure for 2017/18 and their budget allocation.

Central bodies claim these areas have been historically overspending their ‘fair share’ of NHS funding and do not have affordable financial plans for this financial year. Consumer groups in some areas, however, argue that historical under-funding of clinical commissioning groups in their regions has not been adequately accounted for. Some providers have also challenged the assumption that the spending caps allocated to providers and commissioners are both fair and achievable.

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