A BLUEPRINT for a healthcare system fit for the 21st century - with revised roles for primary, secondary and social care services - is to be devised for Gwent.

New ways of delivering Gwent-wide and local services will be plotted up by Gwent Healthcare Trust and the area's five Local Health Boards (LHBs) for discussion and inclusion in an overall service plan.

Only when this is completed will talk turn to the facilities required to deliver it - including replacement of the Royal Gwent Hospital.

An ambitious timetable has been put on completion of the service model. It proposes discussion and agreement by next winter, with agreement later in 2004 on the facilities required.

The trust and the five LHBs, from Newport, Torfaen, Blaenau Gwent, Caerphilly and Monmouthshire, will each draw up service plans.

"None of these component parts can move ahead without the others. Each area will develop a local service model," said Kate Watkins, chief executive of Newport LHB.

"We will form a local steering group to look at what service model we would like in Newport that would be sustainable for 10-20 years.

"The trust and LHBs will work with the same terms of reference. When the six pieces of work are put together there will be a large degree of common thinking.

"Only then will we look at designing facilities to meet the service model. We won't do it the other way round, that will not work.

"The whole idea will take several years to develop, because capital costs will be substantial.

"Initially it is a very ambitious timetable, but the trust is keen to move ahead because of concerns over the infrastructure of the Royal Gwent and St Woolos."

The revamp will shift the focus on delivery of health and social care.

More emphasis on preventing hospital admissions, a wider role for primary care, greater separation of emergency and elective activity will be key considerations.

The findings of the Wanless Review into health and social care in Wales will be fed into the planning process of what will form the biggest shake-up in the system in Gwent since the founding of the NHS in 1948.