A trust which is using the Internet to fight for survival is pinning its hopes on a 'radical' new plan to preserve acute services at three hospitals.
Kent and Canterbury Hospitals trust claims the rescue plan is based on a clinical 'consensus' which could be a model for the post-white paper NHS.
It could put an end to a bitter and protracted row over hospital reconfiguration in east Kent, although there are fears it could raise 'inappropriate expectations' among the public.
'We have a palpable sense of a change of mood, ' said communications manager Chris Ryan.
The trust opposes plans put out to consultation by East Kent health authority, which, if approved, would see it lose many key services.
The HA has argued that it will not be safe to provide care for emergency patients at three major acute sites because of concerns about the quality of junior doctors' training.
Under the HA's proposals, Kent and Canterbury trust would lose most of its beds as well as its accident and emergency department. But two other hospitals - the William Harvey in Ashford and the Queen Elizabeth the Queen Mother on the Thanet coast - would be enhanced.
Kent and Canterbury trust says the HA proposals fail to address real problems and will lead to 'high-risk disruption'.
It has counter-attacked with proposals that have gone on to its campaigning web site. Drawn up by a team of senior clinicians and backed by the trust's board, the trust's plan says there should be a single integrated trust for acute services in East Kent.
All three hospitals would keep their core acute services - acute medicine, 24-hour A&E, maternity and paediatrics.
Doctors would be organised on an east Kent basis in clinical teams, rather than under three separate groups working independently.
Junior doctors would rotate between all three hospitals to meet their training needs.
The proposed 'three-site solution', it is argued, would address issues of medical work practice, recruitment, and training while meeting public demand for locally accessible services at Ashford, Canterbury and Margate.
'This solution contrasts with previous options, in that it solves the problems by integrating the work of doctors around east Kent rather than displacing thousands of patients and their relatives, ' the document adds. It claims that a flexible way of providing services at all three hospitals is the key, not the fixed organisational arrangements of the three trusts.
The plan does not lay down a rigid structure for specialist and sub-specialist services.
'The flexibility of this project allows clinicians to put aside present political divisions and get together within the overall framework described to agree the placement of their specialty or subspecialty and service pattern of delivery.'
The plan calls for a 'new direction' that breaks down the existing barriers between clinicians and 'puts the interests of patients above those of the trusts'.
Mr Ryan said that the proposals had been well received so far.
Dr Mark Downes, Kent and Canterbury medical director, said the trust set 'ambitious, achievable objectives with high-quality patient care at their heart'.
East Kent HA spokeswoman Alison Pemberton described the trust's plan as 'a very significant response to consultation'. She added: 'Everyone needs to understand that the new direction would also involve significant changes to which services would be delivered at each site.
'We are not prejudging it and want to hear what the specialist consultants have to say.'
Tomorrow's Health Care for East Kent - A New Direction can be accessed at http://www.kch-tr.demon.co.uk