A Hemel Hempstead Hospital feasibility study is considering an option to no longer accept patients who come to the A&E department by ambulance.

The West Herts Hospital Trust, which runs the unit, said A&E would remain open only for patients referred by GPs or going there under their own steam.

The hospital has a budget deficit of �14m and fears this could double if nothing is done in the next 12 months.

Managers have implemented a cost savings programme which will see the current year's overspend limited to �4m bring their debt in March 2006 to �19m.

Emergency cases

Nick Evans, director of service redesign at the West Herts Hospital Trust, said: "The restructure of operations due to be completed over six years has been brought forward.

"One of the options concerns blue-light accident and emergency services which could be concentrated at Watford General Hospital and at other hospitals in north Hertfordshire.

"The ambulance service would take patients to the one which is nearest.

"Hemel Hempstead would have an A&E department dealing with patients referred their by GPs or who arrive under their own steam.

"It is anticipated that 80% of current cases will still be dealt with there.

"We have brought the plan forward because we need to take steps to balance our budget over the next few years.

"The long-term plan is to have a specialist surgery unit at Hemel Hempstead where much of our planned work is already carried out."