The plans affect the A&E department at Bishop Auckland General Hospital
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People are being asked for their views on planned changes to hospital services in County Durham, which could lead to the closure of a casualty department.
Following a review by County Durham and Darlington NHS Foundation Trust, a 14-week public consultation has begun.
One option is to shut Bishop Auckland's A&E department and concentrate main acute services in Darlington.
Under the other proposal, the unit would still close, but additional care provision would be offered on the site.
Both options would turn Bishop Auckland General Hospital into a centre for supporting and complementing Darlington Memorial Hospital and University Hospital of North Durham.
'Strong future'
Local health services and 24-hour urgent care would also operate alongside.
Chester-le-Street Community Hospital and Shotley Bridge Community Hospital would remain unchanged , although under both options there would be an increase in the number of operations carried out at Shotley Bridge's day surgery unit.
Stephen Eames, chief executive of County Durham and Darlington NHS Foundation Trust, said: "Following the Seizing the Future review, we know we need to make changes to ensure that we provide the best services for patients, while maximising the use of all of our hospital sites.
"We have therefore proposed two options which we strongly believe would enable the Trust to achieve better outcomes for patients and secure a strong future for each of our hospital sites.
"The consultation process will be an opportunity for the public to have their say on these proposals and feedback their thoughts and comments."
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