NHS England managers are secretly planning major cuts to services, says a health service think-tank.
The King's Fund claims local health officials and councils have been told not to publish proposals for closures and have been given advice on how to turn down requests made under the Freedom of Information Act.
Chris Ham, the chief executive of the King's Fund, says the government told NHS England "we don't want too much noise" about the plans and instructed local managers accordingly.
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Patients have been "largely absent" from the debate about planned cuts, the think-tank added.
It said: "National NHS leaders wanted to be able to 'manage' the STP [sustainability and transformation plans] narrative at a national level – particularly where plans might involve politically sensitive changes to hospital services."
At least one hospital and several A&E departments and maternity units could be shut down. Local MPs are expected to fight the plans once they become public, says the Daily Telegraph.
The paper adds that NHS managers have rebelled against the instruction to stay quiet and say drawing up such plans without local consultation is "ludicrous" and likely to end in a "massive fight".
"Increasing numbers" of NHS trusts and councils have reportedly broken ranks, the Telegraph continues, "publishing or leaking documents which set out plans for major changes to services, arguing that the public deserves honesty".
Katherine Murphy, of the Patients Association, says advancing the proposals in private risks creating unworkable changes that could endanger patients.
She said: "The secretive nature of these plans is simply not good enough. If done badly, this could put patients at risk. It is about closing hospitals and services and there are concerns we do not have the funds to provide the alternatives."
Dr Tajek Hassan, the president of the College of Emergency Medicine, added: "Secretly producing plans without involving those who are, or should be, at the heart of the NHS - the patients - is wholly unacceptable and will not result in effective or sustainable services.
"Transparency is also needed to address the current speculation regarding the potentially catastrophic closure of emergency departments, which - if true - would only add to the substantial difficulties emergency medicine faces and put lives at risk."
A spokesman for NHS England said at least half of the 44 proposals would be published by the end of the week and that it had always been the health service's intention to consult on the final plans.
"I am sure there are things that could be learned about the process but when you are trying to improve care across a whole system, things are never going to be straightforward," added Professor Sir Bruce Keogh, NHS England's medical director.
