Hospital chiefs have started work on a five-year plan which will lead to major changes in the way health services are provided in Bradford as demand rises ahead of expected income.

It was revealed in yesterday’s Telegraph & Argus that the city’s health and social care services face a projected shortfall of £364 million in the next five years and the city’s hospitals will have to cope with £135m of that figure.

Work has now started on a plan for the next half decade to ensure the NHS Teaching Hospitals NHS Foundation Trust can provide the health services the public need without spending more than it has coming in.

Final decisions will be made later, but it is likely that increasing numbers of patients will find themselves being cared for at home or in the community rather than going into hospital.

The emergency care provided through A&E, which is heavily used in Bradford, will also be changed to ensure patients get the correct type of care as quickly as possible once the enter the hospital.

But despite tightening finances, it should mean improvements for patients.

Director of finance Matthew Horner said: “We want patients in Bradford to feel they have a seamless journey, not that they are being transported from one organisation to another.

“There will be patients in hospital who could be better cared for at home, supported by community care services. That would release capacity in hospital to allow us to meet demand.”

Work had already started to treat patients away from hospital where possible, but so far the number of beds freed up by those patients had been absorbed by growing demand.

It may be that demand grows faster than beds can be made available by treatment some patients at home.

However, if in-patient numbers are reduced, that may have an impact on the size of hospital sites eventually.

“We have saved bed days already, but because demand has gone up, it is eating into that,” said Mr Horner.

Already, money is being set aside for a new budget called the ‘better care fund’ which will pay for the carers who will treat patients who remain at home or who are discharged earlier than previously expected from hospital after treatment.

Other potential changes involve making hospitals work better, investing money which has been previously saved into modern buildings and siting linked services near to each other to improve efficiency and quality of care for patients.