SENIOR politicians are calling for openness on how the NHS is set to transform amid fears there could be a major impact on A&E services at Whiston Hospital.

There are fears Whiston's A&E department could face increased pressure from taking patients from a wider area if proposed changes come into force.

The plans come as part of a major sustainability and transformation plan (STP) for NHS health services across Cheshire and Merseyside, that has been sent to NHS England for feedback, drawn up response to financial pressures totalling £900m across the region.

According to the leaked 58-page document, A&Es at Whiston and Warrington could "re-profile opening hours with activity flowing to other 24/7 centres". Among the concerns are that one of the hospitals' emergency departments will close overnight.

Three possible models are suggested for A&E services at Whiston, Warrington and Southport & Ormskirk hospitals, with proposed changes including measures such as sharing rotas and federating staff.

Councillor Andy Bowden, acting leader of St Helens Council, says there are concerns that the development of the plan have not been transparent.

Cllr Bowden said: "St Helens, like a number of councils nationally, are concerned about the process which has been applied in the development of the NHS Sustainability and Transformation Plan.

"The process is not transparent as the council, local politicians, patients and the public have not been allowed to play any part in its development.

"We intend to look at the implications that this plan proposes and will make suggestions for improvements on the basis of it being in the best interests of the people of St Helens."

He added: "Locally the council, St Helens CCG and St Helens & Knowsley NHS Trust are working well together to develop St Helens Cares, a new model which will bring health and social care provision together with preventative work.

"It is hoped this joined-up approach will lead to better patient and community outcomes. We believe that this ground-breaking approach is ahead of anything being been done elsewhere in Cheshire and Merseyside and puts St Helens at the forefront of healthcare provision while still protecting our essential public services."

A spokeswoman for St Helens and Knowsley Teaching Hospitals NHS Trust said: "The NHS is facing challenging times. To meet these challenges partnership working is becoming increasingly important."

She added there are "intentions in some areas to conduct reviews of current urgent and emergency care services", to assess whether there may be "clinical or sustainability issues which should be addressed".

She added: "This may lead over time to options being proposed to change the way some services may be delivered in the future. Any proposals would also be subject to public engagement and consultation. This is very much the start of a conversation."

The spokeswoman continued: "The trust is working partners at Warrington and Halton Hospitals NHS Foundation Trust, Southport and Ormskirk Hospitals NHS Trust, 5 Boroughs Partnership NHS Foundation Trust, Bridgewater Community Healthcare NHS Foundation Trust, NHS Clinical Commissioning Groups and local authorities to form 'the Alliance'.

"The Alliance is looking at how services are currently delivered across the area, and ways to make them more sustainable in the future."

She added the Alliance, as part of the Cheshire and Merseyside STP, recently submitted draft proposals to NHS England. A final plan will be published on November 16 after feedback has been received.