THE people of Devizes have been told another review of health services is under way just a month after the end of the consultation period over proposals to scale down Devizes community hospital .

It is a case of dj vu for many who fought off previous plans to close the existing hospital in Commercial Road in 1993 and the maternity unit in the early 1990s.

But the latest review seems to be even more worrying, coming as it does at the end of the recently extended consultation period over services currently provided at Devizes' community hospital and when the project to build a new hospital in the town is behind schedule

No firm plans have been drawn up, despite land being set aside for a new hospital at Devizes' Green Lane since the closure of Roundway Hospital in 1994/5.

The timetable drawn up by the Kennet and North Wiltshire Primary Care Trust envisaged building work starting on the £10m hospital in October this year but that will not happen as agreement over what services the new hospital will have has still not been reached.

The review of all health services is being carried out by the Primary Care Trusts in Kennet and North Wiltshire and West Wiltshire, which have faced cash crises since being formed two years ago.

Both trusts have a zero star rating, the worst possible, and are being run by an acting joint chief executive, Stephen Golledge since the departure of their respective chief executives.

Mr Golledge, who was brought in from West Gloucestershire Primary Care Trust, is overseeing the service review and admits that community hospitals will probably not remain in their current guise.

He said: "There might be a range of services being carried out in district general hospitals and community hospitals which can be provided in expanded GP surgeries and beds might be contracted to be provided in residential and nursing homes.

"It's unlikely that when you look at the shape of services in the next three to five years what we see now will continue.

"What health services we provide in the community in the future might not look like the traditional hospital that people know."

Mr Golledge said the role of all nine community hospitals would be looked at. The close proximity of Devizes and Melksham hospitals could result in services being consolidated at one hospital site.

Mr Golledge said: "We have not come to a view on the relationship between Devizes and Melksham hospitals but where there are facilities reasonably close together we need to look at whether services are duplicated and it could be that some services are provided at one site and some services provided at another site."

The Primary Care Trusts were formed in 2002 (West Wiltshire PCT in 2001) and from the start were spending more money than they were receiving.

This included contributing to a historic debt at the Royal United Hospital, Bath. This year both Primary Care Trusts need to find combined savings of £13m.

Kennet and North Wiltshire Primary Care Trust's overspend this year is in the region of £6m and this includes an unexpected overspend from last year of £1.6m, which the Audit Commission is investigating.

The trust runs four hospitals, Chippenham, Devizes, Malmesbury and Savernake, at Marlborough.

Kennet and North Wiltshire Primary Care Trust received £3.9m in support from the NHS bank last year and is due to receive £2.9m this year.

West Wiltshire Primary Care Trust received £1.9m from the NHS bank last year and is expecting to receive £1.8m this year. The trust runs hospitals in Bradford on Avon, Melksham, Trowbridge, Warminster and Westbury.

Avon, Gloucestershire and Wiltshire strategic health authority is in negotiations with the Department of Health about how much of the money the trusts have to pay back.

A spokesman for the strategic health authority, in Chippenham, said the support from the NHS Bank could result in lower amounts of money from the Department of Health in future years when the savings have been achieved.

She also said the trusts could not use the proceeds of any buildings it owns, such as hospitals, to pay off overspends. The money from any sales would have to be used for future building projects.

She added: "The SHA's requirement and expectation was that the PCTs' boards and management would deliver agreed services and targets within the money available including the bank support. The current situation is not acceptable, which is why further action is required. The PCTs have been asked to prepare an action plan for delivering financial balance by early July."

Meanwhile DASH2 (Devizes Action to Save Our Hospital) is determined to continue the fight for a new hospital in Devizes.