EVESHAM hospital patients face a nightmare scenario of longer waiting times for consultations and treatments, run the risk of picking up infections and could be treated by untrained staff, according to a damning report compiled by a health service union.

Unison also issued a stark warning that the problems could lead to legal action by patients against South Worcestershire Primary Care Trust.

The body, which represents health sector workers, sent its alarming report on the implications of the proposals for staff at Evesham Community Hospital and across the county to South Worcestershire Primary Care Trust chief executive Mike Ridley.

The document, written by Unison regional organiser Edna Hall on behalf of the staffside joint negotiating consultative committee, calls for the four primary care trusts in Worcestershire to disband and become one.

It said this would cut management costs and prevent South Worcestershire Primary Care Trust's £5.7million deficit being recovered through the reduction of front-line health services.

"We seriously put that forward," Ms Hall said. "They have quadrupled the cost with four chief executives. There could be savings made there. There have been no savings made from management level, or they have not been clearly identified to the staff."

Ms Hall said she was asked to co-ordinate the report for union representatives from throughout the county's health sector after receiving a record number of complaints and comments from staff who would be affected by the changes.

"I have never handled a consultation period with so many comments. There will be job losses and there will be downgrading. Staff have been restructured and restructured and morale of staff is now at rock bottom," she said.

The document said the current standard of seeing patients within 30 minutes at Evesham's minor injuries unit could not be maintained if the number of trained nurses were cut from two to one.

They also warned the increased waiting times could lead to more patient complaints and, in the worst cases, legal action, which would wipe out any financial savings gained by staff cuts.

A life-saving cardiac treatment, which was going to be introduced at the unit, could not be operated by only one member of staff, it was claimed.

The report also stated the one nurse in minor injuries could not be on-call for cardiac problems at the hospital and ward staff at the hospital could not help at the unit because of the risk of infections being transmitted.

They also said trained nurses who help at the GP out-of-hours service at the unit should not be replaced by untrained staff because this would put patients at risk.

The report said: "These ill-conceived changes will greatly restrict any inroads we may have made towards improving emergency care for the local community."

Janet Ferguson, communications manager for the South Worcestershire Primary Care Trust, said the trust was not prepared to comment on the Unison report until after the trust's board had discussed the issues involved on Wednesday, June 4.

Councillor Liz Eyre, cabinet member for social services, health and wellbeing, said the trust has agreed to pay £17million into the Pooled Budgets for Older People for joint projects, which she said would help them avoid gaps and use the money more efficiently.

She said the proposal in the trust's consultation document for the county council to fund occupational therapists, social workers attached to GP practices and the day rehabilitation unit at Evesham Community Hospital was a pointless route which could have cost the county council more than £1.5million.

Instead, the cabinet voted last Thursday (15) to pass back the interest on the £17million which the trust has given to the pooled budget, which will allow them to meet those costs this year.