Regional plans to reform health services and improve life expectancy threaten to reinforce existing postcode lotteries and create a “fragmented” NHS, doctors have told The Times.

In the past six weeks the nine regional strategic health authorities (SHAs) outside London have published detailed “vision documents” of changes they would like to enact in their areas, as part of the wide-ranging review of NHS services being conducted by Lord Darzi of Denham, the Health Minister.

Lord Darzi wrote a report for NHS London last year in which he proposed the creation of 150 polyclinics to supplant GPs’ surgeries in the capital.

But the prospect of maternity units, accident and emergency wards and GP surgeries merging or closing has been criticised heavily by doctors and patients’ groups who fear the loss of vital local services.

The SHAs plans vary in scope and ambition, with some setting out detailed targets for life expectancy or pledging to stamp out superbug infections within ten years.

Some of the more ambitious aims include NHS South West’s to match the highest life expectancy rates in Europe within five years – although already more patients can expect to reach the age of 75 in this region than in any other part of the country.

Patients in the West Midlands can expect measures to reduce 40,000 preventable medical errors in hospitals each year.

But other areas are less specific, and reiterate existing targets such as one-to-one midwifery care. Priorities for most parts of the country include improving care for the terminally-ill, improving access to family doctors on evenings and weekends and treating those who have suffered strokes or heart attacks in specialist units.

Lord Darzi is expected to consolidate the regional visions in his final report on the NHS “Next Stage Review” at the end of this month. It will be the culmination of a process which, he says, has considered the views of 60,000 people and 2,000 doctors.

But the British Medical Association said that consultation on the documents had been “extremely patchy”. “In some areas, it’s been abysmal, with no real engagement. In others it’s worked quite well,” a spokesman said. “The overwhelming mood, however, is one of dissatisfaction, or anger.

“In areas like the North East, doctors are frustrated that the local vision documents announce grand sweeping plans - that clearly require extra investment - without any detail about how they are going to be achieved.”

In the meantime, NHS organisations have been offered guidance to ensure reforms are “local, clinically-led, evidence-based and in consultation with patients who use the service”. However. doctors fear a patchwork approach. Nigel Watson, a GP from the New Forest and chairman of the Wessex Local Medical Committee, said: “You need flexibility to cater for the individual populations and needs of different areas but patients would prefer to have a national system where they can be sure of the standard and quality of care.”

Peter Holden, who runs a surgery in Matlock, Derbyshire, said he feared that the reforms in the East Midlands would redefine discrepancies between urban and rural areas.

Lord Darzi insists that the changes are not a “national blueprint” being imposed by Whitehall, but rather will be controlled by regional health authorities on a local level.

His report will attempt to remove any overall “obstacles to change” in terms of funding or management, he told The Times. “The challenges in the North East, or London, are very different to the challenges in the South West, or elsewhere.”

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