A DEADLINE of November 1 has been set for the largest-ever shake-up of medical services in East Lancashire to begin to take effect.

Burnley General Hospital's accident and emergency department will shut under the Meeting Patients Needs programme - with all critical casualty cases transferring to the Royal Blackburn Hospital.

The programme, which has sparked controversy across the area, needs to meet the November 1 target or face £40,000 in extra costs per day, health chiefs have been told.

Urgent care centres will be established at both the Blackburn and Burnley sites as part fo the plan.

But all in-patient emergency, surgical emergency, trauma and intensive care beds, alongside emergency assessment work, fracture and trauma clinics and vascular surgery, will be located at Blackburn.

Conversely all orthopaedics, general surgery and breast services will shift to Burnley General by November.

Only paediatric in-patients will remain at Blackburn - a day-time observation unit will continue at Burnley and a similar 24-hour unit is planned for Blackburn.

Planned changes to maternity and obstetrics medicine, and the creation of a midwife-led birthing centre at Burnley begin in December, with in-patient gynaecology services moving to Burnley by March or April.

Blackburn will be the location for the consultant-led birthing unit, under the proposals.

The cardiology department, stroke medicine, diabetes services and chronic obstructive pulmonary disease treatment will also be centralised at Blackburn.

Meanwhile all rehabilitation services have been earmarked for the Pendle Hospital site.

The programme represents the first phase of MPN's implementation, with further services expected to transfer between the hospitals by spring 2008.

Initially the neonatal intensive care unit for East Lancashire NHS Hospitals Trust will be sited at Blackburn, with a lower-level unit at Burnley.

But it is anticipated that the neonatal department should be ready to transfer, in full, to Burnley, by early 2008.

Other critical support services, such as radiology, blood sciences, microbiology, endoscopy and pathology are expected to move on a staged basis to Blackburn by next spring.

Consultations began last week with staff who will be affected by the move.

In September the MPN board plans to stage a public awareness campaign outlining the various switches.

Coun Tony Humphrys, vice-chairman of Blackburn with Darwen council's health scrutiny committee, said: "It does concern me that people in Blackburn with Darwen might not be fully aware of these proposals, and that there will be issues with people attending patients being treated at Burnley General."

Coun Gordon Birtwistle, leader of Burnley council, said that the town's general hospital was losing everything - and only getting 10 per cent of services back in return.

"We are like a third-world country in terms of health provision in Burnley," said Coun Birtwistle, "which is totally unacceptable."