The review claims that moving the Albion Park airport-based helicopter to Sydney would have little impact on response times for patients in Wollongong.

The move is certain to cause anger in the community which undertook a three-year campaign before the previous government eventually agreed to establish the 24-hour medical helicopter at Illawarra Regional Airport in 2008. In 2011 the Wollongong chopper spent 548 hours in the air performing 384 missions.

Bases in Newcastle, Tamworth and Orange would become 24-hour, seven-day-a-week operations should the NSW government adopt the recommendations of the independent review by Ernst & Young.

The long-awaited review found there will be a 23 per cent increase in demand for the state's medical chopper fleet over the next decade and, unless changes are made, mission response times will significantly deteriorate statewide.

Major proposed changes are:

• Ceasing winching operations out of Wollongong and Tamworth and restricting them to just four bases: Sydney, Canberra, Newcastle and Lismore.

• Investigate moving the Wollongong service to a planned new mega-base in Sydney.

• Review the future of the Lismore service once a new Gold Coast retrieval service is established.

• Increase operating hours and staff at Orange, Tamworth and Newcastle bases from 2014.

• Slashing the number of dedicated aeromedical regions from five to two.

The proposals will spark a backlash from many regional communities concerned they are not adequately serviced by aeromedical services.

NSW is serviced by five different types of helicopters. The state's fleet totals 15. The review has recommended moving to just two models of identically configured helicopters.

"It is estimated that this strategy, combined with changes to the number of existing regions and helicopter operators could result in reducing the fleet from 15 to 12 helicopters and the number of back-up helicopters from six to three with the potential to deliver a recurrent annual saving of around $6.7 million," the report found.

Taking into account the potential savings and cost of implementing the other Ernst & Young recommendations in full, the cash-strapped NSW government will need to find another $7.3 million a year by 2020 to fund the cost of medical helicopters.

A NSW Health spokeswoman said the report had been sent to 150 stakeholders for comment including the Ambulance Service of NSW, clinicians, a critical care taskforce, hospitals, unions and MPs.

The government will respond once the formal submission period closes in February.