Fears of a potential downgrading of accident and emergency care in

Sussex were confirmed by health chiefs today.

An official document outlining potential hospital changes across central Sussex includes moving all emergency surgery from Haywards Heath to Brighton as one of three options.

Today, NHS bosses invited residents and patients to have their say about the proposals, which could eventually cost £40 million during several years, as they were made public for the first time.

In June, the Argus exclusively revealed the accident and emergency department could be downgraded at the Princess Royal Hospital (PRH), in Haywards Heath, with emergency surgery based at the Royal Sussex County Hospital, Brighton.

The Argus is campaigning for the proposal to be dropped.

This morning, East Sussex, Brighton and Hove Health Authority chief executive Alan Bedford said: "This is not about change for change's sake. Medical knowledge, technology and patients' expectations are continually developing and health services must adapt to keep pace."

The discussion document, called Modern Hospital Services for Central Sussex, outlines three options.

Hospital managers want to reorganise services so enough patients with certain ailments are seen by different doctors so skills remain honed and medical specialties flourish.

The first option involves keeping services at the two hospitals as they are. The second involves most emergency care being based at the Royal Sussex and most non-emergency care grouped at PRH.

The third and most controversial option, which has been favoured by the board reviewing changes, involves all trauma (car accidents and broken hips) and emergency surgery being treated in Brighton, with such medical dramas as asthma, stroke or heart attacks treated nearest to people's homes.

The Argus has been campaigning to stop accident and emergency care being down-graded at PRH, which has been strongly supported by the community.

As part of the changes, managers are also keen for a specialist women's health unit to be based at the PRH.

Under all recommendations children's and maternity services would still be provided a the PRH and Royal Sussex. Cardiac surgery and renal care for the whole of Sussex would continue in Brighton.

A public consultation process will now begin, running until October 13.

West Sussex Health Authority acting chief executive Michael Taylor said: "National advisers suggest it may not be possible to continue to organise services as they are now."