The two districts are among the first in the county to come under scrutiny by North Yorkshire and York Primary Care Trust (PCT) as it reviews its services to ensure they meet the future health needs of local communities.

One idea could see the establishment of large new health centres – or polyclinics – to replace traditional GP practices.

Doctors and other clinical staff will lead the projects which will set investment priorities in the area from 2009/10 and decide how patients access care.

Under the scheme local GPs, consultants and other healthcare professionals working in primary care services, such as nurses, will be involved in developing a long-term strategy for the future of local health care services.

The PCT says the views of local people are also vital to the long-term planning of local health services and over the coming months they will be consulted on the matter.

Dr Vicky Pleydell, GP at Harewood Practice in Catterick Garrison and Clinical Executive Chair for the PCT, said: "Having lived and worked in North Yorkshire for 20 years I am committed to safeguarding the high quality care we already enjoy, while also continuing to improve care by making it more focussed on the needs of individual patients and their families and making care available closer to home if feasible and safe.

“These reviews must be led by local clinicians, working in partnership with the patients and public they serve."

The PCT will be outlining the projects to the North Yorkshire County Council Overview and Scrutiny of Health Committee when it meets today in the village of West Burton.

The committee has long been a strong supporter of maximising clinical and medical services at the Friarage Hospital in Northallerton and its chairman, Coun John Blackie, says they will be looking closely at what is being proposed.

“We need to hear the views of the key players first before we draw our own conclusions,” he said. “If they are to go ahead in North Yorkshire there needs to be meaningful engagement process with patients and local people.”

The PCT's Director of Nursing and Patient Care, Gary Hardman, said: "Our aim, with our partners across the health and social care community, is to begin discussions on how local NHS services will look in the future, developing strategies to secure safe, fair, effective and personalised health services for the population of North Yorkshire.

“This work is still at the early stages but it is important that we involve partners like the Overview and Scrutiny Committee in order to ensure the views of local people are represented from the start."