BOSSES have said the future of maternity services at one of the region's smallest hospitals are in grave doubt.

New limits on the working hours of junior doctors are having an impact on hospital services across the country.

But smaller centres, such as the 250-bed Friarage Hospital in Northallerton, North Yorkshire, are being disproportionately affected.

Yesterday, managers and senior doctors from the Friarage said they were involved in a fight to maintain a 24-hour, consultant-led maternity unit.

Other areas of concern in the long-term are emergency services, anaesthetics, general surgery and services for women and children. Trust officials said they were determined to retain as many services as possible.

One way is to share more medical posts between the Friarage and the James Cook University Hospital, in Middlesbrough, which are run by the same NHS trust.

Fiona Bryce, a consultant gynaecologist and obstetrician from the Friarage, said: "None of us wants to lose the maternity service here. We are fighting hard to retain it."

New staffing arrangements are so unusual that they have to be approved by the Royal College of Obstetricians and Gynaecologists (RCOG). As part of the new set-up, the unit will have more middle-grade doctors. Crucially, five middle-grade doctors will start work at the Friarage next month.

The working arrangements will have to be approved by the RCOG in a year's time.

Miss Bryce said: "Consultants have been living in for three to four months to keep the service going, but we cannot do it on a long-term basis."

Her comments were made ahead of today's meeting of the trust's Clinical Futures Board.

The board, which is looking at the best way of organising emergency services, anaesthetics, general surgery and services for women and children at the Friarage, has invited representatives from local authorities and members of public forums to discuss the way forward.

A £21m revamp is under way at the Friarage to create a block containing new neonatal, paediatric, pathology and women's health services.

Doctors said the Friarage problems were unrelated to the parent trust's cash crisis, which is forecasting a £13m overspend by the end of the financial year.