What will health and social care be like in 2021?

That is the stark background to what has been described as the biggest shake-up to the NHS in a generation, following an inquiry by the investigations team of our publisher, Johnston Press.

The major overhaul is set out in a number of Sustainability and Transformation Plans (STPs), with England divided into 44 areas.

There are around 1.7million people in the Northumberland, Tyne and Wear, and North Durham footprint, which covers the boundaries of six clinical commissioning groups, six local authorities and a number of providers.

The worst-case scenario – a funding gap of £904million – is the sixth highest out of the 44 STP areas in England. Based on a population of 1,7million, it requires a £531.76 reduction per person.

Two of the main criticisms of the plans, which are due to be finalised in April, are that the public is almost entirely unaware of them and that they are so full of jargon and vague assertions that critics have said the impact of the plans is unknown.

A consultation on the draft STP for Northumberland, Tyne and Wear, and North Durham ended last month and the full plan, as well as a summary, can be found on all of the CCG websites.

It explains that the focus in the North East is increasing work on ill-health prevention and improving wellbeing; increasing collaboration between organisations providing out-of-hospital care; and closing the gap in the finances.

However, the summary also adds that ‘we don’t yet know the detail of what will change’, but ‘the draft STP sets out what organisations in the different areas will be doing over the next two years’.

In Northumberland, the key focus will be continuing the ongoing development of an accountable care organisation (ACO) – an over-arching body to manage health and care services which will be a national first.

The overall area could see a four per cent reduction in the workforce (1,671 posts), but the plan says this ‘will largely be delivered’ by removing current vacancies, not replacing staff on a like-for-like basis and using staff ‘in a revised skill mix’.