PATIENTS needing hospital treatment may have a shorter wait in future but they could also face a longer journey for treatment as health services in South Bucks enter a period of change over the next few years.

Planned changes at Wycombe and Stoke Mandeville hospitals are likely to see more services concentrated at one or other hospital. Already urology is centred on Wycombe while ophthalmology is based at Stoke Mandeville.

A review of acute services, such as accident and emergency, paediatrics, surgery, medicine obstetrics and gynaecology, and orthopedics has been going for two years and could see these also concentrated on one or other hospital. There has already been fear that Wycombe Hospital will lose its accident and emergency department to Stoke Mandeville.

Buckinghamshire Health Authority says that Wycombe and Stoke Mandeville hospitals are not big enough to go it alone any longer because they don't serve large enough populations.

Some consultants only see a small number of particular cases and this hits their expertise. Some are the only consultant in their field in the hospital, so are on 24 hour call and without holiday cover. There are not enough staff to run a system where junior doctors can be overseen by seniors, and keep their hours below the maximum number. The universal problem of attracting staff also applies.

The health authority says that while some patients will travel further it is a trade off between convenience and treatment. South Bucks has appointed a second consultant cardiologist and when there is a second at Stoke Mandeville they will work together and cover for each other.

South Buckinghamshire NHS Trust chief executive Roy Darby said: "The good thing is that this will shorten waiting times and we may be able to do more things rather than sending people to London or Oxford".

Building a new hospital is not on and neither is putting all in-patients in one hospital. Mr Darby said: "They will both remain as general hospitals.

"It's difficult and a challenge because the solutions are not easily identifiable. There is no single solution and we have to work it through carefully."

The changes will be made possible by the likely merger of the administration of Stoke Mandeville Hospital in Aylesbury, to create a single trust for the whole of the county, excluding Milton Keynes.

A project board made up of the chairman of Buckinghamshire Health Authority, the chairman and chief executives of South Bucks and Stoke Mandeville Trusts and representatives from the primary care groups was set up three months ago.

It will report later this year as to whether the two hospitals should merge and there will be the usual public consultation, though it may be that all people themselves decide is a name for the new trust.

Why is it being done? Ostensibly to save money, because there will be only one board of directors and executives and work to implement the NHS plan can also be done jointly. With one set of people at the top for both hospitals, contentious decisions to concentrate services on a particular hospital will be easier to get through.

Mr Darby said: "I can see us going through a period of change, organisational and clinical. The message I want to give is that we are working very hard in what we believe to be the best interests of the patients, to improve the quality of our services and to be able to provide services for mid and south Bucks."