A reshaping of hospital services in the east of England could result in the accident and emergency departments of Bedford or Milton Keynes hospitals being downgraded, commissioners have announced.

A review by a multiagency team, including NHS England, regulatory bodies and Bedfordshire and Milton Keynes clinical commissioning groups, indicated “sustaining emergency surgery on both sites is not sustainable long term”.

A statement from Bedfordshire CCG said there were five options under consideration. Each one “involves the continuation of A&E services at one or both of Bedford and Milton Keynes, and a broad range of emergency and planned services on both hospital sites,” it said.

“The precise scope of those services and how they can best be organised to benefit patients is part of the further work that we will undertake next.”

The team’s report will be submitted to the two CCGs this month. Following their sign off, the proposals will be subject to a public consultation later this year or in early 2015.

NHS England said it does not expect either Bedford or Milton Keynes to provide hyper acute specialist services. This would rule the CCGs out of being “major emergency centres” under the Keogh review.

Bedfordshire CCG chief operating officer John Rooke said that while no decisions had been made, he expected networking arrangements to continue to develop between Bedford and its local tertiary centre, Cambridge University Hospital Foundation Trust.

He said: “Bedford and Addenbrookes already have a relationship. They have a number of joint posts, there are well established cancer pathways.

“Some of the discussions we are having at the moment are around children’s cancer services and whether could be delivered in Bedford instead of Cambridge through networking arrangements between the two hospitals.”

Both health economies are facing long term funding difficulties. In 2013-14, the health economies of Bedfordshire and Milton Keynes faced a deficit of around £9m and £12m respectively, according to a review briefing document published in April.

Bedford Hospital is forecasting a loss of an additional £25m by 2018-2019, the briefing document said.

Bedford and Milton Keynes hospital trusts are among a raft of smaller NHS acute providers facing downgrades as hospital emergency departments are set to be reclassified as part of NHS England medical director Sir Bruce Keogh’s urgent care review launched last year.

Sir Bruce has proposed between 40-70 of the existing A&Es become “major emergency centres” offering a higher level of staffing and expertise, while others face potential downgrades.

There are currently 140 non-specialist hospital trusts with type 1 A&E departments in England. These are defined as “a consultant led 24 hour service with full resuscitation facilities and designated accommodation for the reception of A&E patients”.