Two of the most challenged health economies in the country are relying significantly on major service reconfigurations, which are likely to require public consultation, for savings.

The NHS Yorkshire and Humber QIPP tracker highlights the high risk to savings in North and Mid Yorkshire. NHS North Yorkshire and York is predicting a £19m deficit for the current financial year, while Mid Yorkshire Hospitals Trust expects a shortfall of more than £20m.

The strategic health authority has rated NHS North Yorkshire’s savings plan as ‘amber’ overall.

One of the primary care trust’s QIPP proposals rated amber is that “estate will be rationalised… this will drive out £4.5m efficiency”. But the tracker highlights that this is “depending on a consultation for acute service reconfiguration”. It says there are “risks highlighted around the level of dependency of the consultation [on] configuration”.

An HSJ Local Briefing on North Yorkshire and York said in June that major reconfiguration proposals – likely to require public consultation – were expected to be developed over 12-18 months.

Meanwhile the PCT cluster for Mid Yorkshire – Calderdale, Kirklees and Wakefield – is also rated ‘amber’ overall on the tracker.

One of the cluster’s two QIPP plans rated amber is for “development of alternative community care services” closer to patients’ homes and delivering improved outcomes.

The QIPP tracker assessment warns that a decision to delay plans for a consultation on major reconfiguration at Mid Yorks until 2012 could reduce savings this financial year. The decision to delay was made earlier this year so new more radical plans can be drawn up, following the arrival of a new chair and chief executive at the trust. The QIPP tracker adds: “The [delay to the] reconfiguration of [Mid Yorks] will disrupt and potentially diminish our QIPP plans and we may be forced to post delays in subsequent months.

“However – this is by no means certain. There is a very significant amount of work being done and ‘grip’ being maintained at a very senior level that is unaffected by any decision to delay.”

Most of the PCT clusters that estimated their reported QIPP initiatives would achieve less than half of the savings they needed to make between 2012-13 and 2014-15 were based in the North of England. Of the 11 clusters that valued their reported QIPP initiatives at less than 50 per cent of the required savings they need to make over that period, only three were based outside the north.

Among the five clusters whose QIPP plans amounted to the lowest proportions of their planned savings by 2015, three were based in the North East – County Durham and Darlington, North of Tyne, and South of Tyne and Wear –  and two, Lancashire and Merseyside, were based in the North West.