Trust's hit list to save £13m includes:

l Reducing sexual health clinics

l Changing podiatry services

l Fewer home visits for elderly

l Altering health visitors' work

l Relocating district nursing

l Closing Pershore Cottage Hospital before new one opens

l Closing three units at Evesham Community Hospital

OUT-of-hours doctor surgeries, sexual health clinics, school nurses and physiotherapy are all on a hit list of health services facing cuts.

South Worcestershire Primary Care Trust has revealed a list of services it is looking to change or axe in a desperate bid to save £13m.

As well as countywide services, the list includes proposals to reduce services at Evesham Community Hospital - including closing the day rehabilitation and palliative care units and temporarily shutting the Bredon rehabilitation ward.

Pershore Cottage Hospital also doesn't escape, with a proposal to close the hospital ahead of the new one opening and transfer patients to Evesham.

The PCT must save £13m in 2006/2007 after money was taken from its budget to help sort out the national NHS financial crisis.

The trust has stressed the proposals are just ideas and has invited patients to come up with their own suggestions about how it can save money.

But there are still fears the changes could mean bad news for patients.

Alex Stewart-Cleary of South Worcestershire Patient and Public Involvement Forum said reducing the number of sexual health clinics could see a rise in the number of people contracting sexually transmitted infections.

The number of people infected with chlamydia in South Worcestershire has already risen from 571 in 2002 to 654 in December 2005.

"I worry whether this proposal goes against government guidelines," said Mr Stewart-Cleary. There's already a serious outbreak of STIs in this area.

"I also have serious concerns over reducing home visits to the elderly. If someone is housebound there needs to be reassurances that they will still be visited in their own home."

Coun Malcolm Meikle, chairman of the health scrutiny team at Wychavon District Council, said he had particular concerns about reducing the GP out of hours service.

"I already know of someone that waited 20 minutes to have their call answered before being told that they could not be seen at Evesham and would have to travel to Worcester," he said.

"I have a feeling that these proposals would see Evesham hospital closed altogether. Also we don't know what the Acute Hospitals Trust is going to come up with yet to save £30m. The poor patient is being squeezed at both ends."

The PCT's acting chief executive Paul Bates said: "These ideas are still `work in progress' but we want to discuss them at the earliest stage with key stakeholders, so that we can take their thoughts into account as we try to achieve the very difficult task of living within our budget.

"That way we can help to minimise the negative effects and explore alternative ideas. We are not yet at the formal public consultation stage, but this is an important chance for early discussion.

"At the moment, the PCT does not envisage compulsory redundancies, although it cannot rule them out completely at this stage."

The board of the PCT will agree a final list of proposals to be discussed with the county council's health scrutiny committee on June 7, 2006, who can decide whether they need to go out to public consultation.

Anyone with a money-saving idea can write to Janet Ferguson at South Worcestershire PCT, Isaac Maddox House, Shrub Hill Road, Worcester, WR4 9RW or

e-mail janet.ferguson@ sworcs-pct.nhs.uk