That was the conclusion of the British Medical Association’s analysis of the Government-ordered ‘Sustainability and Transformation Plan’ for the area. According to the organisation’s figures, Sussex and East Surrey needs £491.5m to deliver its plan, which is one of 44 being delivered across the country. The Central Sussex and East Surrey Alliance, which includes the Brighton and Hove Clinical Commissioning Group area, needs £277m to deliver capital expenditure projects listed within the STP. Alongside the £450m transformation of Brighton’s Royal Sussex County Hospital site, the STP includes almost £500m of capital projects to improve the NHS estate and digital infrastructure that ‘our transformative new models of care need to thrive’. These include reconfiguring the A&E at Royal Sussex and Brighton General Hospital, alongside a community hub at Preston Barracks. The plan says: “Acknowledging the shortage of centrally-held capital, we are planning an innovative and diverse range of capital sources.” These include a mix of commercial capital partnerships and commercial loans. Mark Porter, BMA’s council chair, said: “These figures are especially concerning given that everyone can see a huge crisis unfolding within our NHS, with record numbers of trusts and GP practices raising the alarm to say they already can’t cope. “The NHS is at breaking point and the sustainability and transformation plan process could have offered a chance to deal with some of the problems that the NHS is facing, like unnecessary competition, expensive fragmentation and buildings and equipment often unfit for purpose - but there is clearly nowhere near the funding required to carry out these plans.” Health providers, including those running A&E departments, are having to cope with rising demand for NHS services due to an ageing population on top of a huge shortfall in funding and workforce issues. The plans have been drawn up to encourage more community care and the integration of health and social care. In East Sussex and Surrey alone NHS organisations are facing a £864m funding gap by 2020/21 under a ‘do-nothing’ scenario, with £530m of savings planned in the STP. The organisations in the ‘Central Sussex corridor’ including Brighton and Hove are looking to create a multispecialty community provider (MCP) model with the aim of moving specialist care out of hospitals and into the community. When members of Brighton and Hove CCG attended a Health Overview & Scrutiny Committee meeting back in December, they explained that changes were needed to reduce unnecessary hospital admissions and provide solutions to a national shortage of GPs, promising future engagement with residents. Late last year Brighton and Sussex University Hospitals NHS Trust entered into an agreement where it will share the leadership of Western Sussex NHS Foundation Trust in a bid to improve its performance and escape from special measures. Campaigners including the National Health Action Party have raised concerns about the speed, transparency, and accountability of the changes laid out in the STPs. A spokesman for the East Surrey and Sussex STP programme said: “(The plan) brings together all organisations involved in delivering health and care services and represents a real shift in the way that the NHS works, with organisations collaborating to respond to the challenges facing local services and communities. “This work will involve some costs because it involves working at a regional scale – something we’ve never done before – across multiple organisations, delivering hundreds of different services, to tens of thousands of different patients.” A Department of Health spokesman said: “We are committed to the NHS — that’s why we have invested £10 billion in its own plan to transform services and improve standards of care, including almost £4 billion this year. “NHS England are introducing Sustainability and Transformation Plans to help ensure the best standards of care, with local doctors, hospitals and councils working together in conjunction with local communities for the first time.”