Dozens of patient organisations are backing plans to close hospital services in coming years, but fear they will be let down by bad public engagement.

National Voices, the umbrella group representing many patient groups, including the Stroke Association, Cancer Research UK and the National Childbirth Trust, has said closures will “sometimes be the right outcome” as the NHS faces investment cuts and growing demand.

Not all local hospital care is good enough, safe enough or in the right place

In a report published this week it acknowledges that after the general election, plans for “primarily cost driven” major service changes will emerge in many areas.

Early plans, for example in London, propose dramatic cuts in hospital capacity in favour of primary and community care.

The National Voices report Share the Power says: “The reflex ‘Save our local hospital’ is the line of least resistance and not always the right one.

“Not all local hospital care is good enough, safe enough or in the right place. Many patients want to have more care and treatment nearer to home.

“Too many people are admitted who shouldn’t be, and stay longer than they should or want to.”

But it says good quality involvement of the public and patients - which often does not happen - will be important.

It says pressure from funding cuts could “exacerbate” the problem of poor consultation and highlights research from the Independent Reconfiguration Panel showing that the most common shortcoming in NHS plans is a failure to engage in the early stages

National Voices chief executive Jeremy Taylor said the NHS needed “a creative and outward looking approach to involving the local population and patients. Organisations should have the leadership and courage to make the case for change [in] the interests of patients”.

The report warns of a “risk that major service change will fail to improve quality and responsiveness to patient need, and could make things worse”.

It says: “The local NHS needs to really understand the needs of those it is there to serve.”

It also calls for feedback and complaints channels to be simplified, with a single phone number, and for clinicians to be more accountable for how they communicate with patients.

“Doctor knows best” paternalism gets in the way of patient centred care and self-management, it adds.

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