IS said to be facing the biggest cash crisis since it was launched almost 70 years ago.

The National Health Service, one of Britain’s most cherished institutions, is struggling to cope with an ever-increasing gulf between the cost of meeting demand and the amount it receives in funding.

New figures show that the NHS budget deficit has more than tripled to an eye-watering £1.85 billion.

This week it was revealed that health chiefs in Hampshire and the Isle of Wight must save almost £600 million over the next five years.

The size of the black hole facing healthcare providers in the area is laid bare in a new masterplan produced by local clinical groups in a bid to identify the best way to meet the challenges ahead.

For the first time organisations across the area have combined their individual action plans to produce an overall strategy.

The draft Sustainability and Transformation Plan (STP) has taken eight months to complete and highlights the full extent of the task facing NHS bosses. It warns that the health service in Hampshire and the Isle of Wight will face a £577 million shortfall if care continues to be delivered in the same way.

Similar documents are being produced in 43 other parts of the UK as officials face a combination of budget cuts and soaring demand.

The STPs seek to achieve the seemingly impossible task of improving patient services and reducing costs at the same time.

Issues identified in the Hampshire plan include the ever-increasing demand generated by the county’s ageing population, with the number of older, sicker residents rising all the time.

A contributory factor is the From previous page relentless growth of towns and cities across Hampshire and the corresponding rise in the number of patients.

Tens of thousands of homes are due to be built in the county over the next 20 years, including a large number in the New Forest. Campaigners claim many of the properties will be bought by pensioners retiring to the south coast, which already has a high percentage of senior citizens.

The STP outlines some of the ways in which the health service aims to adapt.

Under the plans the NHS will strive to reduce the amount of time patients spend in hospital by treating more people at home as well as providing extra care in the community.

Almost 20-per-cent of NHS land will be sold off to reduce costs by £24 million but the role of community hospitals will be expanded.

Other parts of the masterplan focus on prevention rather than cure. Smokers will be given more help to quit the habit, a diabetes prevention programme will be rolled out across the county and cancer screening will be improved to ensure that people who have the disease are identified earlier.

But retired Hampshire GP Dr Iain MacLennan and other critics are describing the document as a potential blueprint for cuts.

One of their main concerns is that the proposed shake-up will lead to more services being concentrated in larger centres, with an ever-increasing number of Isle of Wight residents being sent to the mainland for specialist NHS treatment.

Healthwatch Isle of Wight said it hoped the final version of the plan would reflect the “unique challenges” faced by Islanders trying to access services.

However, Healthwatch Hampshire stressed that many patients in the area covered by the STP would face shorter journeys for treatment.

A spokesman said: “These plans have been developed by health and care organisations from across Hampshire and the Isle of Wight in response to the increasing challenges facing the local system.

“The plans build on existing programmes of work taking place throughout the county and are changing the way that health and care is provided in many ways.

“Some offer patients more choice about when and where to receive treatment, less travelling time to attend appointments and less time waiting for appointments, diagnostic tests and test results.

“Other changes may mean patients travelling further than they do today to make sure they receive the very best care possible for their condition.”

Mims Davies, Tory MP for Eastleigh, welcomed the STP.

“People are living longer and demand for healthcare is growing, with many living with chronic conditions,” she said. “It’s absolutely vital we start to look at services and how they are delivered across all sectors.”

Ms Davies said many of the letters she received from constituents were generated by health-related issues.

She added: “Being in an area where we have no acute services and people have to travel often, how things are set up for the long term is absolutely vital.

“I’ll be reviewing the document fully so that I can continue to make sure my constituents get the best possible outcomes from this programme.”

Steve Brine, Tory MP for Winchester, also voiced support for the proposals.

He said: “My constituents want access to world-class services but we know that healthcare needs have changed and the NHS needs to adapt if it’s to keep pace.

“With more elderly people, greater awareness of mental health issues, higher expectations of cancer treatment and the care we get from hospitals at weekends, we’ve a huge challenge.

“I welcome this plan, which has been developed by local doctors and health professionals – not politicians – and its ambitions for our area.

“But the real interest for me comes next year when we expect a decision on the future of acute and emergency care at Winchester Hospital. I am working closely with the local NHS to make the case for the services we need.”

Alan Whitehead, Labour MP for Southampton Test, added: “The good news about the STP is that all the providers across both health and social care have got together to plan joint strategies.

“That can only be good in terms of making sure that the best pathways for admissions treatment and aftercare are used and the resources of all the bodies are jointly engaged in it.

“The bad news is the question of whether this coming together is about better working or survival in the face of cuts in resources.

“The picture you get from the plan is that whilst smarter and more joined up working can make more efficient use of resources, it’s the backdrop of the looming funding shortfall that has driven the process.”

Dr Whitehead said the NHS was hoping that different ways of working would help it meet the shortfall in funding over the next few years.

He added: “There are some eye-watering projections about smaller numbers of admissions, appointments and short hospital stays, as a result which - if the plan does not work perfectly - will simply register as cuts.

“And that means a poorer and less available service with longer queues and in some instances services simply disappearing.”

Royston Smith, Tory MP for Southampton Itchen and former leader of Southampton City Council, said the NHS was one of the country’s greatest achievements.

He added: “Ensuring it continues to deliver the very best care for everyone it treats is of paramount importance. “In order for the NHS to remain sustainable we have to look at the demand on the service and the needs of patients over the coming years.

“There is clearly a significant growth in demand with an ageing population and many people living with long-term health conditions. If anything this is a testament to the success of the NHS, although we must acknowledge the challenge this presents.

“I believe the plan put forward by our local NHS commissioners and staff provides a robust framework to meet the challenges the NHS faces.

“The plans to improve the support for those with long-term conditions is important as it will mean people will have the right advice and support to manage their own conditions and should make it possible to delay the progression of some of these conditions.

“Reducing the length of time people remain in hospital after they have finished their treatment ensures we have the best care for patients in an environment where they feel comfortable.

“This plan will mean the NHS will change locally and that will require all of us to adjust in some way, although I am assured that this plan will engage with local communities and I am confident that this process will enable our hardworking NHS staff and patients to help shape the future of local services.”

Shadow health secretary Jon Ashworth has described the cash crisis facing the NHS as the biggest in its 68-year history.

The British Medical Association (BMA), which represents doctors, has voiced concern over what it describes as the “impossible” scale of savings sought by STPs.

BMA chairman Mark Porter said: “Any proposed changes can only deliver real improvement when given adequate investment.

“Doctors are becoming increasingly concerned that the primary focus of NHS transformation is not on delivering the best possible patient care, but in cutting back budgets and, therefore, services.

“The government must not use these transformation plans as a cover for further starving services of resource and patients of care.”

The Chancellor, Philip Hammond, has vowed that the service will receive £10 billion of extra funding a year by the end of 2020-21.

area. But the real interest for me comes next year when we expect a decision on the future of acute and emergency care at Winchester Hospital. I am working closely with the local NHS to make the case for the services we need.”

Alan Whitehead, Labour MP for Southampton Test, added: “The good news about the STP is that all the providers across both health and social care have got together to plan joint strategies.

“That can only be good in terms of making sure that the best pathways for admissions treatment and aftercare are used and the resources of all the bodies are jointly engaged in it.

“The bad news is the question of whether this coming together is about better working or survival in the face of cuts in resources.

“The picture you get from the plan is that whilst smarter and more joined up working can make more efficient use of resources, it’s the backdrop of the looming funding shortfall that has driven the process.”

Dr Whitehead said the NHS was hoping that different ways of working would help it meet the shortfall in funding over the next few years.

He added: “There are some eye-watering projections about smaller numbers of admissions, appointments and short hospital stays, as a result which - if the plan does not work perfectly - will simply register as cuts.

“And that means a poorer and less available service with longer queues and in some instances services simply disappearing.”

Royston Smith, Tory MP for Southampton Itchen and former leader of Southampton City Council, said the NHS was one of the country’s greatest achievements.

He added: “Ensuring it continues to deliver the very best care for everyone it treats is of paramount importance. “In order for the NHS to remain sustainable we have to look at the demand on the service and the needs of patients over the coming years.

“There is clearly a significant growth in demand with an ageing population and many people living with long-term health conditions. If anything this is a testament to the success of the NHS, although we must acknowledge the challenge this presents.

“I believe the plan put forward by our local NHS commissioners and staff provides a robust framework to meet the challenges the NHS faces.

“The plans to improve the support for those with long-term conditions is important as it will mean people will have the right advice and support to manage their own conditions and should make it possible to delay the progression of some of these conditions.

“Reducing the length of time people remain in hospital after they have finished their treatment ensures we have the best care for patients in an environment where they feel comfortable.

“This plan will mean the NHS will change locally and that will require all of us to adjust in some way, although I am assured that this plan will engage with local communities and I am confident that this process will enable our hardworking NHS staff and patients to help shape the future of local services.”

Shadow health secretary Jon Ashworth has described the cash crisis facing the NHS as the biggest in its 68-year history.

The British Medical Association (BMA), which represents doctors, has voiced concern over what it describes as the “impossible” scale of savings sought by STPs.

BMA chairman Mark Porter said: “Any proposed changes can only deliver real improvement when given adequate investment.

“Doctors are becoming increasingly concerned that the primary focus of NHS transformation is not on delivering the best possible patient care, but in cutting back budgets and, therefore, services.

“The government must not use these transformation plans as a cover for further starving services of resource and patients of care.”

The Chancellor, Philip Hammond, has vowed that the service will receive £10 billion of extra funding a year by the end of 2020-21.