A HUGE shake-up of how hospital services are provided could end up with the county losing one of its accident and emergency departments.

The county has three main hospitals with two of these, Worcestershire Royal at Worcester and Redditch’s Alexandra, currently having A&E departments, while Kidderminster Hospital is a treatment centre with a minor injuries unit.

However, the organisation which runs these hospitals – the Worcestershire Acute Hospitals NHS Trust – is grappling with a £50 million shortfall going forward due to a growing elderly population, a forecast recruitment shortage of qualified doctors and the Government-imposed spending cap on the NHS.

These problems prompted the trust’s launch of a joint services review in January to work out how to provide “safe and affordable” services to the county from 2015.

The trust, which has had 100 doctors, nurses and consultants helping to discuss what its options could be, has now put forward six versions of how its service might look – maintaining all three sites – in the future.

Of these, the only two versions which would see the Royal and the Alex both keep an A&E department are said by clinicians to be unworkable, given different pressures building on the service.

The other four versions – or models as the trust is calling them – set out a single A&E-equipped hospital, with two other hospital locations taking on other services, such as planned surgery, handling out-patients and scans.

These remaining versions also reflect the prevailing view of health chiefs that people should be looked after in their communities, with social care, district nurses, GPs and community hospitals playing their part.

Between them, the county’s NHS healthcare providers have to effectively save £200 million to stay ahead of the growing strain on all health services.

The hospital trust’s share is £50 million, as Christine Fearns, the joint review’s project director, explained.

She said Worcestershire had an increasing number of elderly people growing above the national average, with the burden of higher levels of chronic illness, creating a challenging environment.

Mrs Fearns said expert evidence was also pointing towards providing expert teams of clinicians, round-the-clock, seven days a week being the only way to maintain quality of care and being able to provide the most up-to-date treatments.

She also said there were challenges recruiting some specialist doctors and with no more cash from the Government until at least 2015, the money has to go further.

The six versions of hospital care will be cut down, forming a shortlist of viable options, which will then trigger a full-blown three-month public and clinical consultation.

Creating that shortlist is being done by applying a set of criteria, including what quality of care could be provided, people’s access to the services, how the changes meet staff needs, how easy it will be to deliver the changes and how well they will fit together with other health services such as community hospitals.

Mrs Fearns said affordability and value for money would also factor in shortlisting.

The hospitals trust says it is choosing now to publicly reveal what the likely options are to be, rather than face criticism at a later date that it did too little to let people know what was happening.

Mrs Fearns said: “We’re giving people an early chance to have a say on the modelling and we would refine the wording of the criteria if the public want us to. It’s work in progress.”

NHS chiefs have stressed that no decisions have been made about where individual hospital services would go, be it Worcester, Redditch or Kidderminster, in the versions which have been worked up.

Nick Purser, consultant breast surgeon at the Royal, said: “It’s about quality of care, not the building itself.

“The location issue will come up – that’s a legitimate worry. But when we get to the consultation we will be saying it’s about quality of care, not location.”

Public exhibitions detailing the shake-up are being held across the county, including at County Hall in Spetchley Road, Worcester, from 10am to 2pm on Saturday, July 7, and at Pershore Civic Centre from 10am to 2pm on Wednesday, July 4.

A public consultation on the short-listed options starts in the autumn.