REDUCTIONS in numbers of qualified nurses, 'new roles' for Oxfordshire's community hospitals and fewer beds in the John Radcliffe and Horton General Hospitals are being considered by cash-strapped health bosses.

A leaked document this morning reveals the measures are part of a cost-cutting exercise to save £479m across Oxfordshire, Buckinghamshire and West Berkshire.

The joint plans said much of the savings would come from prevention and a shift from hospital care to care at home or in local communities. 

This included 'a shift of acute activity away from the John Radcliffe and Horton hospitals' and a 'redesign of community hospital care'. There would also be 'changes' in obstetric services and paediatrics at the Horton, it added.

Across all three areas, 'workforce savings' of £34m have also been proposed. 

It said this meant 'skill mix changes to support a more flexible workforce– use of generic support workers', including a 'reduction of nursing grade input' and 'increased use' of less-qualified healthcare assistants and 'physician associates' who support doctors.

The document, a 'sustainability and transformation plan', is one of several controversial plans developed largely in secret by NHS officials.

Research by the King's Fund published earlier this week criticised NHS trusts for leaving patients 'largely absent' from the work.