A resignation letter from four accident and emergency consultants has heavily criticised the management of Worcestershire Acute Hospitals Trust and local reconfiguration plans.

The four A&E consultants - Richard Morrell, Sarah Crawford, Christopher Hetherington and David Gemmell - resigned en masse from the trust’s Alexandra Hospital in Redditch last month after all securing jobs at Warwick Hospital.

Their joint letter to the trust - published on the trust website - accuses “successive management decisions” of undermining services at the Alexandra, which they say has “led to the self-fulfilling prophecy of failing and unsustainable services”.

But in a response letter from the trust’s five divisional medical directors, they say the consultant’s interpretation of events “needed to be challenged”.

Over the last three years the trust has been embroiled in a much delayed review of acute services. Proposals include downgrading the A&E at Redditch to an emergency centre linked to Worcester Royal Hospital, which would take on services such as emergency surgery and inpatient paediatrics.

The resignation of the consultants and the public dispute between them and the trust has exposed the tensions within the hospital, which is also facing an independent review over claims of bullying and harassment.

The consultants claim the proposed model would be “neither an A&E service nor a safe service”.

They claimed they were excluded from key discussions over the reconfiguration plans, adding: “When external organisations have discovered there is not universal agreement for the plans as portrayed by the trust, the trust has been more interested in finding out how they found out rather than addressing the issues of why.

“Meetings were held so that the trust can say it has had engagement, but in the meetings it was very obvious to us all that we were being heard but not listened to. This is despite us raising serious safety concerns about the trust’s plans and the inevitable knock-on effect it would have on the existing severe overcrowding at Worcestershire Royal Hospital.”

The letter says overcrowding in the county’s hospitals was causing harm to patients and putting stress on staff, concluding: “We are battle weary and exhausted by the continuous pressure that we have been under. We can no longer see a way forward to secure safe and sustainable A&E services at the Alexandra Hospital, especially whilst the current senior management and senior clinical leadership remain in place.”

The response letter from the trust’s five divisional medical directors highlights the difficulties for smaller hospitals to maintain emergency services, which it says are widely acknowledged and understood across the NHS. It adds: “Change, even when essential for patient care, can be difficult and inconvenient for staff, but facts need to be faced and will not be altered if we fail to confront them.”

The response says the proposals had support from local commissioners, NHS England, an independent clinical review and royal colleges.

“It would be wrong to suggest [the four consultants’] views are shared by all of our clinicians at the Worcestershire Acute Hospitals Trust. They are not,” the letter says.

“Also in their letter the four emergency department consultants have voiced criticisms of their colleagues in a manner which we would respectfully suggest is neither professional, or appropriate.”