It is understood the future of the A&E departments and maternity services at Boston Pilgrim Hospital will form a key part of a widespread money saving review.
Existing facilities at other hospitals - including Skegness and Louth - will also be on the agenda.
A&E departments could effectively be ‘downgraded’ with urgent cases transferred to Lincoln General Hospital which would be a ‘major’ emergency centre.
Politicians have already expressed their concerns about the proposals and one councillor this week said she feared someone could die because of the extra journey times involved in ferrying patients to Lincoln.
A United Lincolnshire Hospitals Trust (ULHT) spokesman – which runs the Pilgrim - said: “No decisions have been made on the future of our A&E and maternity services.
“United Lincolnshire Hospitals Trust is committed to delivering safe, high quality affordable services.
“We are working closely with our clinical commissioning groups and County Council as part of Lincolnshire Health and Care review which will consider proposals to provide good quality, sustainable services for all.
“As part of a national review into urgent and emergency services, led by Sir Bruce Keogh, it is being proposed that hospital A&Es will be re-classified in the future.
“For example they may become ‘emergency centres’ or ‘major emergency centres’.
“This is being looked at by the Trust and the Lincolnshire Health and Care review team.
“Doing nothing is simply not an option.
“In five years, health and care organisations in Lincolnshire will have a combined budget deficit of over £365m per year if we do nothing.”
Earlier this year The Standard revealed A&E admissions at the Pilgrim have shot up from 39,257 in 2004 to 49,030 last year while inpatient numbers rose from 43,747 to 53,832 in the same period.
Last year the total operating budget for the Pilgrim was £11.8 million.
East Lindsey District Council has voiced concerns about the changes but Coun Sandra Harrison said she has been ‘cautiously encouraged’ by the reaction to a motion the council passed expressing fears earlier this year.
The issue was raised at Wednesday’s Horncastle Town Council meeting where several councillors expressed concerns about the future of services at Pilgrim Hospital - and the extra journey times involved to Lincoln.
Councillor Linda Baker said she feared someone could die, adding: “I fail to see who transferring even more people to Lincoln would help. It would only make the situation worse.”
Other members called for a measured response and the town council agreed to write to the trust stressing its opposition to cuts. It is understood the trust could reveal some details of where cuts may be needed in January.