TENBURY hospital beds will be closed, more patients treated at home and jobs cut as part of a transformation of health services to save £40 million over the next five years.

Worcestershire Health and Care NHS Trust is having to find savings of about £8 million a year until 2017/18, about five per cent ofits overall service budgets.

About 10 per cent of the county's 200 community hospital beds – in Tenbury, Malvern, Bromsgrove, Evesham and Pershore – will close initially, with the potential for more to follow if the new model is deemed a success.

About 300 of 4,500 jobs with the trust are also being cut, although bosses stress they do not envisage having to make significant redundancies, while many staff will be required to re-train.

Spending cuts will be made in mental health, community care and children's services, while community hospitals will become "treatment hubs", offering fewer beds but a greater range of services under one roof.

Services will also be "integrated" across the health and social care system - reducing duplication and meaning patients will need to make fewer visits and tell their story to fewer people to access their treatment.

The changes will not affect Worcestershire's three acute hospitals - Worcestershire Royal, Kidderminster and the Alexandra in Redditch - which are managed by a separate trust and currently the subject of a separate review aimed at slashing £50m from their budgets.

Although the financial element is clearly a huge driver of change, the trust said the main motivation is quality and continuing to improve the experience of patients and service users.

It said it would be re-configuring even if the need for savings was not there and that the new model is backed by its various patient groups, known as locality forums.

Chief executive Sarah Dugan said: "Although there is a financial challenge, the motivation is really about finding new and innovative ways of treating people in or as close to home as possible.

"This is what people tell us they want; whether they are a young person with a mental illness or are elderly, the overwhelming feedback is that people want to avoid going into hospital unless it is absolutely necessary."

Jan Ditheridge, director of service delivery, said closing beds did not mean community hospitals would be any less important in the future.

"We are not going to close community hospitals," she said.

"They are very precious to us and will be increasingly important in the future.

"Where we do remove beds, we will be using the space to provide other things."

She said the beds being closed initially were already surplus to requirements.

Community hospitals will be re-branded community hospital treatment hubs, with fewer beds and more variety and options for treatment – for example blood transfusions, which have traditionally been carried out in acute hospitals such as Worcestershire Royal.

They will also provide a base for new community enhanced care teams – designed to help patients with more complex, high-risk conditions remain safely at home.

There are plans to offer greater opportunities for “choices, control and personalisation” for adult mental health service patients, particularly those with dementia, by providing more care at home.

Services will be reconfigured to be less “bed-based” but specialist inpatient care will still be available for those with the highest level of need.

A 24/7 mental health liaison service, comprising medics, nursing staff and psychology support, will also be created. It will have an emphasis on rapid response and aim to deliver “early but effective” discharge from general hospital admission wards.

Children’s services will be split into three distinct teams; locally-based “integrated teams”, specialist teams providing a county-wide service to the “most complex” young people and an adolescent mental health services team.

All teams will focus on treating children at or closer to home.

A new learning disability crisis resolution service will be created to support people who present with “challenging” behaviour.

The service will be available 24/7 and is intended to complement the work of existing community learning disability teams.