Health chiefs in west Kent say they could be facing a financial shortfall of up to £280million over the next three years.

The funding gap is being predicted ahead of a wide-ranging public sector spending squeeze and is expected to prompt a series of cost-cutting measures.

Steve Phoenix, the chief executive of the West Kent Primary Care Trust, said he was confident levels of patient care could be safeguarded but warned that jobs may go.

He also said that there could be a re-organisation of facilities but that did not mean a programme of closures of clinics or other centres.

Based on Government spending forecasts, GPs and acute hospitals in west Kent are likely to have to deal with a cut in their budgets of between 15 to 20 per cent over the next three years.

"As we have a £1billion budget, the implication for us is going to be over the period somewhere between £180million and £280million...that is four to six per cent per year that we will have to deal with," he said.

Asked if he could be confident that levels of patient care would be unaffected, he said the spending forecasts were still speculative and there remained "a huge level of uncertainty."

"We want to do everything we can to improve services not go backwards. What we do know is that there is a huge amount of inefficiencies in the system and our first job will be to tackle that." He said patients would not lose facilities but health chiefs would have to consider different ways in which key services for patients were provided.

"I do not anticipate a closure programme but we do need to consider whether we can provide complementary rather than competing services, such as providing services in people's homes or at GPs' centres rather than having to travel to a specialist centre." However, if there was no pay freeze for NHS staff, jobs would have to be left vacant.

"Clearly, what we will have to do is contain the amount of money spent on staff. If there is an increase in pay, there will be more pressure on us to contain the number of staff we employ. If there are to be reductions, we would expect to be able to manage it through national wastage."

The news of cutbacks in health spending across west Kent follows last week's news that KCC is facing a £200million shortfall over the next three years and could lose up to 700 jobs.