A high profile review of services in North Yorkshire and York, led by eminent doctor and NHS Confederation medical director Hugo Mascie-Taylor, has come to an end, and is well worth a read*.

The area has overspent and been bailed out for years. Some believe the problem is underfunding of rural areas, but the premise of the strategic health authority-commissioned review was that, as government spending slows and reform takes shape, such aid may well dry up.

Members included clinical commissioning group chairs and the chief executives of councils and voluntary groups. The main acute chief executives (York, Harrogate, Scarborough, Airedale, Hull, Middlesbrough and Leeds), inevitably threatened by meaningful change, were involved. All will also be involved in a follow-up progress review in the autumn.

The review has already won impressive support. There is a hope other areas will learn from it, too. The North Yorkshire bailouts are small beer compared with the 20 per cent saving needed across in England.

Some findings are specific to the area’s well-off but rural population, for example emphasis on community hospitals, but other recommendations will travel.

One proposed innovation is a joint health and social care estate review, looking particularly at co-location. Could this deliver the twin goals  of asset sweating and integrated working?

At the sharp end, the review says at least 200 acute beds should be closed. If those savings do not transpire, “option B” is to close a district general hospital. If there is no change, Professor Mascie-Taylor, says, “the healthcare system will undoubtedly fail”.