NHS bosses have been drawing up plans for drastic cuts, expecting they will need to make savings as a spending boom for public services ends.

These include swingeing reductions to the numbers of doctors and nurses in training, disclosed in last week’s Sunday Telegraph.

However, last-minute pledges by the Conservatives and Labour to block the cuts plans, which conflict with pledges to protect “front line services”, mean health authorities are now desperately looking elsewhere for savings.

The Tories have said they will spend more on the NHS than Labour and the Liberal Democrats – who have only said its spending would keep pace with inflation.

As a result, the NHS has been playing a guessing game, expecting it will need to make savings of at least £15 billion in three years, as demand continues to rise.

This would mean rationalising some hospital services. No party wants to take responsibility for unpopular closures of Accident and Emergency and maternity departments too soon after an election, but mergers of specialist services are being discussed across the country.

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