Hospitals will have to be closed and beds cut as part of a series of money-saving measures across the NHS in England.
A new report from The King’s Fund think tank has warned that the number of hospital beds could destabilise services that were already “stretched to their limits” after the Winter.
Community services were also “feeling the strain” and could not currently cope with an increase in workload, it said.
Sustainability and transformation plans (STPs) have been put forward by NHS chiefs in 44 areas in England as part of a national programme to transform the health service and save money.
The included hospital closures and cuts to some specialist services such as accident and emergency and stroke care.
King’s Fund Chief Executive, Chris Ham said that the NHS cannot “realistically” cut the number of beds when this winter had shown that they were needed.
But he added that also said it needs to throw its full weight behind the plans to stand a chance of pulling them off.
The cuts could include a 44 per cent reduction in inpatient bed days in south-west London and a cut in hospitals in north-west London from nine to five. Hospital beds in Dorset could also be from 1,810 to 1,570.
NHS trusts have reported a £886m deficit for the first nine months of the financial year.
Mr Ham said: “We think it is necessary to do because 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. So politicians need to step up to the plate and be brave.”
Although “there have been examples of consultations in the past which haven’t been well-founded” he added that “where the evidence is clear, that’s where Government and local politicians need to do their job.”
Last November, the King’s Fund said STPs had been kept secret from the public and barely involved frontline staff.
NHS England even ordered local health leaders not to reveal plans to the public and refuse Freedom of Information Act requests.
The STPs will see A&E dropped at a Poole and Bournemouth hospital, hospitals reduced from three to two in Leicestershire and Rutland, four community hospitals closed in Devon, and 200 beds taken away at Nottingham University Hospitals NHS Trust.
Derbyshire plans to slash 400 acute hospital beds, Herefordshire and Worcestershire anticipate a “significantly lower” number, and Cambridgeshire and Peterborough will centrelise orthopaedics, stroke, maternity and paediatric services.
An NHS England spokeswoman said: “The King’s Fund report rightly finds that STPs offer the best hope for the NHS to transform care for patients in a sustainable way.
“They will allow the NHS to take advantage of new technologies, adopt successful practice more widely, and make practical improvements in areas that we know matter most to patients.
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“These proposals are all about putting collaboration at the heart of our care system, with health and local government working more closely together than at any time since the NHS was created. Everyone in the NHS wants help to ensure we can all get excellent care whenever we need it.”
Dr Mark Holland, president of the Society for Acute Medicine, said: “In acute medicine we need to be convinced that moving resources away from hospitals will see a corresponding reduction in our volume of work. The ball is the court of STPs to convince us of ability to deliver on their promises.”
Dr Mark Porter, chairman of council at the British Medical Association, said the plans were becoming “unworkable”.
He said: “From the beginning, this process was rushed and carried out largely behind closed doors, by health and social care leaders trying to develop impossible plans for the future while struggling to keep the NHS from the brink of collapse.”
A Department of Health spokesman said: “These NHS plans – developed by local doctors, hospitals and councils working together with the communities they serve – will help patients get better care by delivering the NHS’s five year forward view, transforming mental health provision, improving cancer care, and delivering better access to GPs.”