Leading medical professionals in the UK have issued an open letter to the main political parties saying that many hospitals will have to close their A&E units, children’s departments and surgical units to help fill a £20bn ($30bn) financial black hole in the NHS.

The letter to the parties, sent to the Guardian, was organised by the Academy of Medical Royal Colleges and signed by bodies thought to represent two thirds of doctors, according to dailymail.co.uk.

Instead of fighting against the possibility of closure, the signatories have advised the next government to be ready to press ahead with widespread rationalisation of hospitals, which they believe will improve care and save patients’ lives.

Large-scale planned service redesign and reconfiguration based on clinical evidence will have to be followed if the NHS is to manage financial pressures without resorting to indiscriminate and damaging cuts, the letter said.