The NHS in East Sussex needs to save £200m over the next five years, it has emerged.

The figure was revealed as the county was named by independent regulator Monitor as one of 11 “financially challenged” healthcare economies in need of extra support.

Health bosses have warned difficult decisions may have to be made as they look to save money while dealing with increased demand from the county's 527,000 residents.

The move is expected to reignite concerns about potential job losses and further changes to how health services are provided.

There has already been anger over the downgrading of the consultant-led maternity unit at Eastbourne District General Hospital and sending pregnant women in need of urgent treatment to the Conquest Hospital in St Leonards instead.

Other changes have included transferring emergency and urgent general and orthopaedic surgery from Eastbourne to St Leonards.

All NHS organisations are required to save a certain amount of their budget every year, but East Sussex also has a history of overspending which needs to be addressed to get the county's health economy back on track.

The county's three clinical commissioning groups (CCGs) are responsible for managing the county's health budget.

They will be working with the county council and NHS providers including East Sussex Healthcare NHS Trust to draw up plans for the next five years.

Extra support and advice will come from a specially appointed advisor who will be brought in at the end of this month Independent regulator Monitor, NHS England and the NHS Trust Development Authority will be paying for the advisor and associated projects.

A spokesperson for the three CCGs said: “The scale of the challenge is |vast.

“We will need to consider how we can deliver currently-unsustainable local services in a fundamentally different way, to provide better care for patients and better value for money.

“This will inevitably involve making bold changes to local services and some difficult decisions over the next few years.

“We cannot do this alone. This is an opportunity for us to work with our partners and with our communities to design local NHS services that meet the needs and priorities of local people.”

Darren Grayson, East Sussex Healthcare NHS Trust’s chief executive, said: “We will work in partnership with our commissioners and whoever is appointed to provide support to ensure we develop fully aligned and sustainable commissioning and provider plans for the next five years that build on the service improvements already implemented.”