The National Audit office has reported the failure of a scheme by the Department of Health and NHS England which was to integrate health and social care allegedly to save money and cut the rise in hospital admissions.

Described as overly optimistic “The Better Care Fund” was set up using £5.3 billion of NHS and council funding in 2015. The plan was to reduce emergency admissions by 106,000, saving £171 million. But emergency admissions rose by 87,000 costing £311 million more than planned.

Bed blocking was to have been reduced by 295,800 days in total but actually increased by 185,000 days. Budget cuts for councils placed huge pressures on arranging and paying for care and delaying discharges from hospitals resulting in an extra cost of £146 million.

Research indicates that up to 15 per cent of A&E departments in England could be closed or downgraded affecting 33 hospitals. This would mean up to 24 A&E departments being involved. There are seven hospitals for which there are clear public proposals for downgrading or closure, coming from sustainability and transparent plans to deal with financial challenges in the NHS whilst “transforming” services.

I would suggest the brave new NHS world embracing social welfare from April 1 funded by inadequate resources with rising demands and a growing population cannot result in the claimed better quality, more and wider services.

What the politicians and experts reckon is not what is becoming clearer and more recognised by the public and the prices paid by those involved as consumers.

Hospitals need more beds and for them to be available locally. Care home places are falling, not rising.

Some immediate rethinks are overdue before problems finally break the systems.

The empire of experts and NHS management are not changed by the STPs which overdo cuts. Poor political judgements and not value-for-money well paid experts, managers etc have shown their abilities and limitations.

The public deserves far better, both as resource providers and consumers.

There are no plans B to fall back on and the future plan is little more than a medieval chart with edge of known world shown and the legend “Here be problems. Begin next reforms”. There is always money to buy “blue sky thinking” yet, not for the important services and seemingly from record employment levels and stamp and tax takes not extra for the NHS now transferring from other areas not all as worthy or beneficial to the majority.

RICHARD MERRISON