THE Kennet and North Wiltshire Primary Care Trust has agreed its blueprint to radically alter health services over the next three years.

At a meeting in Devizes last Thursday, the trust board ratified proposals drawn up after public consultation.

The proposals include new hospitals for Devizes and Malmesbury by December 2005.

The trust plans to build a new hospital in Green Lane, Devizes, alongside a private care home, and GP surgeries.

The existing hospital and family health centre will be sold off to help pay for the new hospital.

The same is proposed for Malmesbury but the location has not yet been identified.

Trust chief executive Barbara Smith said: "We are pouring hundreds of thousands of pounds into old, inefficient buildings that are not fit for the purpose.

"At Malmesbury we have an old, rambling hospital and it costs a fortune to maintain. We are talking about going into partnership with providers, a nursing home for example, to share the running costs of a new building."

A number of services will be lost from both hospitals, most notably some out-patient consultants' clinics.

The number of beds will be less than at the current hospitals. There are plans for the new Malmesbury Hospital to have eight to ten intermediate and palliative care beds and 15 intensive rehabilitation beds are planned for the new Devizes Hospital.

Day surgery will not continue at the new Malmesbury Hospital and a new day surgery centre is earmarked for the Devizes Hospital, but is still not guaranteed.

As part of the changes some out-patient consultant clinics will be lost from Malmesbury and Devizes hospitals from October. The 24-hour minor injuries unit at Devizes Hospital will also have its opening hours cut to 8am to 10pm from October.

After lobbying from local people, the trust has agreed to retain X-ray facilities at the new Devizes Hospital but uncertainty remains over whether it will be provided at the new Malmesbury Hospital.

Project groups are to be set up in Devizes and Malmesbury to put together detailed plans for the new hospitals. These groups will include local people.

The maternity units at Devizes and Malmesbury are also in doubt and the trust is undertaking a survey of 1,000 women following petitions signed by more than 10,000 people and a protest march, organised by the Gazette, attended by more than 500 people.

Decisions on maternity care will be made by the trust in September.

Meanwhile, the new Savernake Hospital in Marlborough is due to open at the end of 2004 and will provide 35 palliative and rehabilitation beds, plus 12 beds for elderly mentally ill people.

A plan for it to have 24-hour minor injuries unit has been shelved and its current hours of 8pm to 10pm will continue.

Chippenham Hospital will be improved. From October it will be the only community hospital to have a 24- hour minor injuries unit.

Consultant out-patient clinics requiring a high level of technical equipment will be held there, rather than at each community hospital.

There will also be 63 beds for intensive rehabilitation, including the stroke unit, and 16 for elderly people with mental illnesses.

Tim Boucher, the chairman of the trust, said: "This goes a long way to achieving the modernisation objectives for patients and carers. We can't continue to spend money we don't have. I believe these proposals will produce lasting benefits to residents."