Plans for a major shake-up of hospital services in Surrey and Sussex are likely to include closing several accident and emergency departments.
Staff across the region have been briefed about possible options under the 'Fit for the Future' programme, co-ordinated by NHS South East Coast. A full consultation on options is expected in November.
Under the emerging options Surrey could lose one A&E department - possibly either Royal Surrey County Hospital in Guildford or St Peter's, Chertsey. If Guildford loses its A&E department there will be no service on the busy A3 between London and Portsmouth and many people in the Guildford area would face a 30-40 minute journey to get to St Peter's.
Epsom Hospital is also to lose its A&E department as part of a separate reconfiguration in south east London.
A&E and other acute services are also under threat at Worthing Hospital, St Richard's in Chichester and the Princess Royal Hospital in Haywards Heath.
However, in East Sussex it looks as if the A&E departments at Eastbourne General Hospital and Conquest Hospital at Hastings will both survive, although one of the two is almost certain to lose its maternity services.
NHS South East Coast says all options going to consultation will have to meet three criteria: clinical safety and quality; access for patients; and helping the health economy achieve financial sustainability. But it warns that the financial situation together with other factors 'will inevitably mean closing some of our smaller hospitals and changing the services provided by some of our bigger hospitals'.
The briefing says that the door is still open for other ideas.
The predominately Conservative MPs in the area have been campaigning all summer against rumoured changes. Several have launched 'Save our hospital' websites while local papers have organised marches and distributed wristbands. In the last two weeks, 12,000 people have joined marches in Eastbourne and Hastings.
Guildford MP Anne Milton is organising a march in the town at the end of October. 'If A&E and other key departments were shut down to save money it would lead to the closure of the Royal Surrey,' she said.
While A&E changes have had the highest profile, there will also be changes to other acute work - which is likely to be concentrated in fewer hospitals - and more care delivered by enhanced community services.