THE PCT says the main changes are a significant reduction in the number of people who will need to be treated in the specialist hospital setting. Some patients, where it is clinically appropriate, will be cared for by community-based services, allowing better use of NHS funds. Where, when and how patients are treated will be decided by clinicians. The NHS will no longer pay for most cosmetic treatments and many other procedures where a cheaper alternative is likely to work. Some patients will also be referred to private sector healthcare providers. Hinchingbrooke's future could still be at risk if hospital and community clinicians and patients do not play their part. Patients' attitudes have a huge contribution to make to securing the hospital's survival, the PCT says. Its advice to patients is to think before using hospital emergency services unnecessarily, which could save £2million a year at Hinchingbrooke alone. Patients should not try to insist on expensive drugs when equally effective generic equivalents are available. Most readers will be familiar with common generics, such as aspirin, paracetamol or ibuprofen. Proprietary equivalents are no more effective but much more expensive - £1.3million a year in Cambridgeshire. And wasted medicines in primary care alone cost the local NHS more than £10million, when patients do not stop repeat prescriptions of drugs they no longer need. There are also lifestyle decisions that can help, such as not smoking, eating healthily, exercising, restricting alcohol intake, taking care in the sun, practising safe sex, and managing stress levels.