Community hospitals and minor injuries units around Cornwall face closure after the council and local NHS trusts revealed their plans for the next five years.

Proposals also including reducing bed numbers while switching to more community focused health provision, including turning some minor injuries units into "community hubs," while NHS bosses refuse to reveal which sites will be affected.

All of these proposals have been laid out in a report accompanying a public consultation, which will run until January, including local events and a survey.

Central government and NHS England has been calling for sweeping reforms to the nation's health services, and in response the Cornwall and Isles of Scilly Transformation Board has released it's engagement document for the county's Sustainability and Transformation Plan (STP).

The board, includes Cornwall Council, the Royal Cornwall Hospitals NHS Trust which operates the county’s main hospitals and the Cornwall Partnership NHS Foundation Trust which runs its smaller units, among other bodies. It has set out the engagement document to outline the transform service’s transformation over the next five years in the face of government budget cuts.

The three stated aims are to: improve the health and wellbeing of the local population, improve the quality of local health and care services, deliver financial stability in the local health and care system.

The document states: “The NHS is spending more money than is allocated and not always in cost effective ways. We know that some people will continue to argue that Cornwall and the Isles of Scilly needs more money for health and care but our focus must be on providing the best possible services within the resources available.”

The 40 page document says that cost cutting “may mean” a reduction in the number of community hospitals, while others will become “community hubs” and the number of beds will be reduced.

It also states that current minor injuries units will be turned into urgent care centres “but on fewer sites.”

Rik Evans, who ran for parliament as the Truro and Falmouth candidate of the National Health Action Party, said in terms of policies there wasn’t a lot he could disagree with in the engagement document, although his concern was the “underlying reason” for the STP, which is that “a lot of money is not going into the NHS from the government.”

He said: “We are going to see cuts and privatisations of services.”

He also said although he didn’t necessarily disagree with running a “spine” of emergency care units west-to-east through Cornwall there was a lack of details about where they would be put and “how far people have got to go to get there.”

He added: “I’m not afraid of change but there’s nothing in that document that gives me hope that we’ll see real improvement, and probably the opposite - I think we’ll see a real decline.

“The only way they can save money is by decanting these hospitals and their staff into the private sector, which after the first year will reduce wage bills by reducing staff.”

Other plans in the STP include focusing on preventing ill health, providing more care at home or in the community - including training more care workers - and moving away from what the NHS calls an expensive and outdated hospital based model.

There are also plans to reduce the number of out of county mental health placements, a high priority in a county with higher than average levels of mental health issues where five per cent of people report long term problems.

But a spokesperson for the partnership said there were no plans to cut maternity care, which has been a concern for other regions currently learning about their STPs.

Garth Davies, director of communications and engagement, at RCH NHS Trust, also said that there were hopes to have an emergency care unit no more than half an hour’s journey from any Cornish residents, although plans were still in an early stage.

He said, however, that the plan had to work within budget constraints and was aiming to “save” £254 million overall, and added: “If people say that they want community hospitals we’ll have to explain what other services we can’t afford.”

He added that the plans were at “early stages” and a full public consultation would come next summer.

The NHS has also said it wants to expand the roles of pharmacists, practice nurses, health care assistants, therapists and other practitioners to reduce pressure on GPs, while recruiting more GPs as around 20 per cent are expected to retire within five years.

The NHS wishes to reduce five factors - alcohol, smoking, physical inactivity, diet and social isolation - which contribute to five diseases which cause 75 per cent of premature death and disability.

It also claims that 60 people each day are staying in a bed at Royal Cornwall Hospitals who don’t need to be there, with 35 per cent of community hospital beds being used by people who are fit to leave.

Phil Confue, senior responsible officer for the Sustainability and Transformation Plan and chief executive of the Cornwall Partnership NHS Foundation Trust, said: “In the next five years, we have a once in a generation opportunity to change the way we provide health and social care services for the people of Cornwall and the Isles of Scilly.

“The current health and social care system needs reform and we must seize the moment. Lifestyles, communities and technology have changed and our approach has become outdated, fragmented and reactive.

“Local services must adapt to meet the needs of the current and future population - including those who visit our region each year. We must put more focus and resources into preventing ill health, keeping people in their homes or communities and adapting services for a growing, ageing and technology enabled population.

“We want to continue to involve the local community in developing the solutions in the months ahead and we want to hear from as many people as possible on the priorities and approach we are taking. The time and opportunity has come to take control and shape our own future.”

The consultation ends on January 20, and there are community events at St John’s Hall in Penzance on Tuesday, January 10 from 7pm to 8.30pm, National Maritime Museum in Falmouth on Monday, January 16 from 3pm to 4.30pm, Truro Health and Wellbeing Centre on Wednesday, January 18, from 3pm to 4.30pm, and Heartlands on Thursday January 19 from 7pm to 8.30pm.

To read more about the local health and social care plans and all the related documents, including survey and community engagement events, go to cornwall.gov.uk/shapethefuture