Health authorities in Trent region are being asked to 'outline a number of potential scenarios' for the future organisation of services as part of a region-wide review.
The regional office has asked trusts and HAs to 'look ahead' three years to assess the impact of national and local drivers for change on the configuration of services and organisations.
Since the submission of 'informal reports' earlier this summer, Trent's 11 HAs have been engaged in 'robust discussions' with the regional office which are due to conclude next month.
The findings will feed into routine mid-year reviews due to take place in the autumn, the regional office said.
The project - called Configuring Services and Organisations Appropriately - was set up after HA and trust chief executives called for a 'proactive approach' to look at the impact of national changes on local services.
The reports examine health improvement, fair access to services, effective healthcare delivery, efficiency, patient and carer experience and health outcomes.
A Trent spokesperson said the regional office 'agreed to facilitate this process, with the proviso that only changes resulting in real improvements in health, reduction in health inequalities or the modernisation of the NHS would be acceptable as models for the future'.