CONTROVERSIAL plans for the biggest shake-up of health services in Dorset have today been unveiled to the public.

Health chiefs have now launched a 12 week public consultation so patients can at last have their say on the future of hospital and community care services amid the worst financial crisis in the history of the NHS.

Dorset Clinical Commissioning Group (CCG) has distributed 75,000 copies of its clinical services review ‘Improving Dorset’s healthcare’ across the county and has announced a series of public events urging people to get involved.

The Daily Echo has seen a copy of the 47-page consultation document and can today reveal preferred 'large-scale changes' include plans to:

* Centralise hospital services in a move the CCG says could save an estimated 60 lives a year despite the loss of 100 hospital beds. The preferred proposal is to designate Royal Bournemouth Hospital (RBH) as the county’s major emergency hospital leaving Poole Hospital for planned care. Meanwhile Dorset County Hospital would remain both a planned and emergency care hospital with changes to its maternity and paediatric services under discussion.

* Close maternity and paediatric services at Poole Hospital and relocate to a new purpose built unit at the major emergency hub at Royal Bournemouth Hospital.

* Merge specialist teams for key clinical areas such as creating a 'single Dorset cancer service' and one cardiac service to provide care operating across the county rather than the existing separate teams on each site which often duplicate the same service.

* Cut the number of community hospitals from 13 to just seven 'community hubs' with beds and a further five 'community hubs' without beds in a bid to create a more 'integrated community service' model so people are treated closer to home.

Health managers in 44 areas of England were ordered to draw up five year sustainability and transformation plans (STPs) setting out how they will reduce costs, change services and improve care in the wake of a £2.45 billion deficit. The Clinical Services Review, launched in October 2014, forms part of the Dorset STP.

Dorset CCG said there are 'unacceptable variations in the quality of care' across Dorset and its changes are necessary to 'ensure everyone has the highest level of care wherever they live and whatever time of the week, day or night' which fulfils Health Secretary Jeremy Hunt's plan for full seven-day services.

They say under the new proposals, the number of unplanned admissions to acute hospitals would be reduced by 10,000. Meanwhile 100,000 outpatient appointments at acute hospitals could be delivered 'closer to home.'

It comes as local health bosses must contend with a growing and ageing population, workforce shortages which have led to millions of pounds being spent on agency staff and a funding gap of at least £158m by 2020.

Before the process was even underway, critics expressed fears the proposals were 'a done deal' with protestors raising concerns about having to travel a long distance for hospital treatment. The consultation document clearly singles out just one particular option as being preferable.

But health bosses are adamant they remain 'open minded' and have spoken out to reassure the public their views will be heard before any decisions are made.

The consultation document outlines exactly how the decision was reached on choosing RBH as the preferred major emergency hospital, which came down to 'access' and 'affordability.'

They say in their current format neither hospital is big enough for the new model of care. Both have around 650 beds but the major emergency hospital would need closer to 1,000 beds according to the CCG.

Health bosses say developing RBH as the major emergency hospital would cost £42m less than Poole and 'it will take a higher percentage of people less time on average to get to Royal Bournemouth Hospital than Poole Hospital in a blue light ambulance.'

Dorset CCG has not confirmed how many wards will need to be closed for relocation in the shake-up, However, the document states '19 more modern wards would need to be closed' if Poole Hospital became the major emergency hospital rather than RBH.

A change that will likely provoke reaction is the relocation of maternity and children's inpatient services from Poole to Bournemouth.

There were 4,935 babies born at St Mary’s maternity unit in Poole last year compared to 385 at RBH – but more antenatal and postnatal appointments took place at RBH than any other centre in the county.

Instead, a new state-of-the-art maternity and paediatric unit would be developed at Royal Bournemouth Hospital.

As previously reported in the Daily Echo, the proposals have led to discussions about the creation of one 'super trust' covering Poole and Bournemouth being back on the cards - three years after a merger was blocked by the Competition and Markets Authority because it 'would damage patients interests by eliminating competition and choice.'

The consultation on the five-year transformation plan will continue until February 28.

A specialist company will analyse the results to inform a set of proposals that will likely be considered for a decision late next year.

Changes to acute mental health services and primary care services based around GP surgeries, pharmacies, opticians and dentists, will be drawn up in separate plans.

Early suggestions reveal super surgeries with up to 50,000 people could be introduced in the radical shake up of GP services. As previously reported, a draft report of the Primary Care Commissioning Strategy and Plan proposes the number of GP surgery sites could be more than halved from 131 to between just 36 and 69.