A controversial plan to cut £277 million from NHS services in Staffordshire 'risks leaving some needs unmet', an independent review has found.

The NHS in Stoke-on-Trent and Staffordshire made the swingeing cuts to services in 2025/26 in order to meet national savings targets, leading to concerns that costs would be 'shunted' onto councils and residents.

Stoke-on-Trent City Council commissioned the Nuffield Trust, an independent think tank, to review the savings programme and look at how they would impact people in the Potteries.

The Nuffield Trust's report says that around £60 million of savings have been made through a 'redrawing of the boundary' around what is viewed as health care – potentially leaving some needs unmet, 'particularly the needs of those who are economically deprived'.

Most of these savings relate to reducing eligibility for continuing healthcare (CHC) packages for people with chronic conditions, and city councillors fear that cash-strapped social care services will have to plug the gap.

Staffordshire and Stoke-on-Trent Integrated Care Board (ICB) was previously an 'outlier' with CHC eligibility 72 per cent above the national average. While it is still above average it is now more in line with other areas.

The Nuffield Trust estimates that an additional 293 adults, including 78 in Stoke-on-Trent, would have CHC packages if eligibility rates had remained the same. According to the city council's own figures, the CHC changes will cost the authority £2.6 million a year due to 53 cases being handed back.

The ICB says it following national guidelines on CHC, and insists that many care packages do not benefit recipients, with some even causing harm because they are too 'restrictive'.

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Sally Gainsbury, from the Nuffield Trust, told the council's adult social care scrutiny committee that it is difficult to tell whether the ICB now has the 'right' eligibility rate, as it varies so much across the country. She believes it is vital that organisations work together to ensure the needs of residents are met.

Ms Gainsbury said: "The ICB has been reviewing personal health budget expenditure to remove items which are not linked to health outcomes. The ICB doesn't dispute that they're beneficial but argues that these aren't a legitimate healthcare expenditure. Questions have been asked as to who will pick up those costs.

"It's very understandable that the NHS, under the pressure it is, is looking to make sure it complies with national guidelines with the costs it is covering. But the problem nationally and locally is how those care needs will be met.

"With CHC care packages the data is very poor. It's hard to understand what the level of need out there is and track the impact. It's important that all statutory organisations work together to reduce the impact on those least able to fight for themselves."

Along with the cuts to CHC, the ICB has also made savings by reducing the number of procedures, such as knee, hip and cataract surgery, being carried out in the private sector, and by making administrative efficiencies. Staffordshire's three NHS provider trusts have also had to make their own cuts as part of the £277 million savings programme.

Dr Paul Edmondson-Jones, transition director at the ICB, says that the savings programme was evidence-based and that the goal was not to 'shift the burden' onto other organisations.

He said: "We welcomed the opportunity to support the Nuffield Trust's independent review. It reinforces the need for the NHS, local authorities and the voluntary sector to work together to ensure limited resources are used in the best interests of our communities.

"Our 2025/26 plan was clinically led, evidence based and designed to deliver fair, consistent standards of care within the resources available.

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"The review confirms the plan was deliverable, applied national frameworks correctly and does not provide evidence of costs being shifted to councils or residents.

"We value our partnership with local authorities and remain committed to transparent, joint working. We will continue to monitor impacts together and use evidence to make the best use of the resources we have, while protecting those most in need."

Peter Tomlin, corporate director for adult social care at the council, agrees that organisations have to work together, but believes it will be 'incredibly difficult' to make further cuts to CHC.

Scrutiny committee members still had major concerns over the NHS savings programme and the impact on Stoke-on-Trent residents.

Councillor Chandra Kanneganti suggested that savings could be made in other ways, such as by merging the area's two mental health trusts.

Councillor Daniela Santoro raised concerns over demand for services being 'displaced rather than reduced' and said the savings would require continued scrutiny.

Clare Trenchard, from Healthwatch Staffordshire, said she saw little evidence of organisations working together at the moment. And she claimed there is an 'absolute disconnect' between what the ICB is saying about CHC and what patients have told Healthwatch.