A MAJOR shake-up of emergency services will see 999 patients taken directly to Gloucestershire Royal Hospital rather than Cheltenham A&E at night.
Other proposals on the table are to move paediatric surgery to Gloucester, but improve the General Hospital's cardiac care recovery unit.
Health chiefs insist the plans are not cost-cutting measures, but an urgent move to improve patient safety, and not because of a lack of funds.
The changes will provide no extra savings to running costs.
Staff have been reassured there will not be any redundancies under the proposals or new recruitment, as middle-grade doctors will transfer to GRH.
Paients needing specialist care in gastroenterology, cardiology and respiratory will be taken direct to Cheltenham, freeing up space in GRH to cope with the extra demand for emergency beds.
At night, Cheltenham's A&E will continue to treat walk-in patients. Doctors will see patients who have been reviewed by a GP. But patients who have critical illness at night in need of emergency treatment will be taken direct to GRH.
It is hoped the changes will improve patient safety as there is less demand for emergency treatment at night and it is harder to get medical cover from doctors.
Medical Director Dr Sean Elyan insists Gloucestershire Hospitals NHS Foundation Trust remains committed to two vibrant district general hospitals in the county.
"When people need specialist hospital services, we need to make sure they are organised in a way that will ensure quality of care, safety of patients and make best use of the resources and expertise available.
"This is our guiding principle in developing proposals for change."
A&E Consultant, Dr Tom Llewellyn said the changes are the best way to utilise existing staff.
"Clinicians have been discussing how best to overcome the challenges we face and how to make best use of the specialist staff and skills available.
"We believe that this proposal, which relates to emergency care at night time, will help us to provide safe, timely services to the people of Gloucestershire, 24 hours a day, 7 days a week."
"The proposal strikes the right balance between providing excellent specialist clinical care in an emergency and maintaining local access to services whenever possible."
The NHS in Gloucestershire will now talk to patients, carers and community partners about the proposals and listen to views.
A booklet called 'Your NHS: Right Care, Right Time, Right Place – Maintaining high quality, specialist services', has set out the proposals.
Speaking of the changes to paediatric care, Consultant Paediatrician, Dr Miles Wagstaff said a shortage of specialist staff had led to the move.
"There is a shortage of specialist doctors and nurses to care for children and bringing together the day case services will ensure we have a sustainable model for the future," he said.
"It will deliver consistent quality of care for all children and their families wherever they live in the county in new purpose built facilities."
The NHS in Gloucestershire will be holding a series of public drop in events across the county during the 12 week engagement period and information will be available on the website.
To view the proposals in full, visit http://www.nhsglos.nhs.uk.