Derbyshire’s QIPP plan is the only one in the Midlands and East region to have been given a “green” overall rating by the strategic health authority cluster.

Within the SHA cluster, the West Midlands shows the biggest difficulties, with four rated “red” and one “amber”. In total, West Midlands QIPP plans are expected to save £652m but, according to the SHA cluster, the plans are at risk largely due to over-performance among acute providers and slippage on targets.

The largest savings area for both the West and East Midlands is reducing acute secondary activity. Plans will rely heavily on reconfiguring care pathways and bolstering community services.

The Birmingham and Solihull cluster aims to save £57m with a 2 per cent reduction in non-elective activity. Staffordshire is looking to save almost £50m by reducing acute non-elective admissions by 23,050 and an urgent care centre at the Mid Staffordshire Foundation Trust A&E.

The Black Country wants to save £38m by reducing elective activity by 4 per cent, while the Arden cluster plans £37m savings by removing 50 beds and cutting the length of stay for over 75s.

East Midlands QIPP plans are expected to save £458.9m but only the Derbyshire cluster plan is rated “green” by the strategic health authority. The cluster aims to limit the increase in first finished consultant episodes to just 0.9 per cent over three years, saving £33m.

Northamptonshire has the largest single QIPP project at £48m with a plan to shift 3,700 acute non-elective attendances to a local tariff and reduce non-elective activity by 22,186.

In Leicestershire, the cluster’s largest project is to redesign emergency care in the city and reduce activity saving £13m.