HEALTH bosses have pledged not to close Winchester hospital wards until alternative services are in place.

But they have admitted there is no major new NHS funding to shift services traditionally delivered in hospital to the community.

Instead, managers propose to shake up health delivery so fewer hospital beds are needed.

Addressing Hampshire County Council's health review committee, Kevin Stewart, newly-appointed medical director of Mid-Hampshire Primary Care Trust, said: "We don't have an awful lot of money to invest. We need to use the resources we have and organise them better.

"I think we can do it but doctors, nurses and professional organisations will have to work in a different way."

Managers plan to shed 75 beds-about three whole wards -at Winchester's Royal Hampshire County Hospital and Andover's War Memorial Hospital as part of huge spending cuts to save £14m by April, 2006.

It has not yet been decided which wards will close but both Winchester and Andover hospitals will be affected.

Under the plan 34 beds will close in July when a new treatment centre enabling more day surgery opens at the RHCH and up to 41 beds will close at a later stage.

GPs will provide a wider range of services, including vasectomies, which were once the preserve of hospital care as well as manage diabetes, arthritis and asthma.

Mr Stewart, consultant in elderly care at the RHCH, said that about a quarter of hospital admissions were unnecessary.

He said: "For some of my frail, elderly patients it happens because there is no alternative. They don't like it. They lose touch with their home environment. It's uncomfortable, inconvenient and sometimes unsafe.

Everyone knows about MRSA, vomiting and diarrhoea bugs, falling and breaking hips-and it's expensive."

Mr Stewart said the problem was that emergency hospital admissions were often seen as the only way to access the system and he said there needed to be an alternative.

He is proposing a rapid community-based assessment service for the elderly.

The PCT has spent nearly £1m setting up preventing-dependency teams in Winchester, Andover and the Meon Valley, including nursing, therapy and night-sitting services.

They cared for people who would have routinely been admitted to hospital.

The plan is to provide greater medical support for these teams with GPs given easier access to consultants' advice.

But county councillor, Anna McNair Scott, vice-chair of the health scrutiny committee, questioned the speed of the bed closures.

She said: "Fewer beds worries many patients and their families. We need to set up the alternatives and pull it all together as soon as possible."

Janet Rowse, director of strategy and planning for the PCT, said the second phase of bed closures was "to make sure services are in place and safe before we take out more beds."

Mr Stewart, who takes up his new post in May, added: "From a clinical perspective, we could not close the beds and hope it all fell into place because it would exacerbate what is happening now.

"More people would come to accident and emergency and we would have fewer beds. I am arguing we must have alternatives in place before we close beds."

Barbara North, chairman of Winchester and Eastleigh Healthcare Trust, said a "substantial building block was in place" with plans for 500 publicly-funded nursing home beds across Hampshire, including 100 in the Mid-Hants area.

She said the hospital trust could still be more efficient, for example, by reducing bed-blocking which takes up between 50 and 70 beds at Winchester and Andover hospitals.

She said: "We could do more to make services efficient and we have to do that as part of balancing the books."