STRUCTURE: Widespread changes to the Leicestershire Health economy have been agreed between the University Hospitals of Leicester and its local commissioners to plug an estimated £400m funding gap over the next four years.

University Hospitals of Leicester Trust has agreed an overarching blueprint to shift acute care into the community under the Better Care Together plan with local clinical commissioning groups.

The plans spell out the direction of travel for the health economy although detailed service by service proposals are yet to be confirmed.

The trust faces a deficit this year of £41m and overall the health economy has overspent on acute care for a number of years.

The plans have been split into two phases and will begin this autumn with the redevelopment of the emergency floor at Leicester Royal Infirmary and the transfer of vascular services from the royal infirmary to Glenfield Hospital.

Leicester General will be developed as a diabetes centre of excellence and will also house other community services. It will also serve as a base for East Midlands Ambulance Service.

Phase two, from 2016 onwards, includes plans for a 40 per cent shift of acute care from the trust to the community, reducing inpatient beds overall by 387 from a total of 1773, saving £11m.

The trust is aiming to reduce beds by 141 based on existing plans to boost community services announced in 2012, 250 beds will be lost as a result of transferring patients who no longer need acute care to community services delivered by the Leicestershire Partnership Trust.

It will also look to cut 212 beds as a result of improving lengths of stay and undertaking more day case surgery.

Leicestershire Partnership Trust will increase beds by 250 for patients transferred from the acute trust but will aim to cut beds by the same amount through delivering care closer to patients’ homes.

Better Care Together is a partnership between 11 local organisations including the two NHS provider trusts and the three local CCGs Leicester City, West Leicestershire and East Leicestershire and Rutland.

John Adler, chief executive at Leicester’s Hospitals Trust, said: “As a result of centralising and specialising services we will improve quality and safety. In reconfiguring our estate there will be a number of options available and we will work on these with staff, partners, stakeholders and the wider community over the remainder of 2014 and into 2015 to establish what these are.”

Professor Farooqi, co-chair of Leicester City Council Commissioning group and local GP said: “There may well be some tough choices along the way, so that services are fit for the future. But this is work in progress. As we develop proposals, we want to ensure that local people are fully informed and able to contribute to this very important debate.”