The trust that ran the scandal-hit Stafford Hospital should be dissolved, administrators have recommended.
The Mid Staffordshire NHS Trust went into administration on 16 April after a report concluded it was not "clinically or financially sustainable".
Critical care, maternity and paediatric services should also be cut, the proposals unveiled by Trust Special Administrators (TSA) say.
The trust's two hospitals will come under two other trusts.
Stafford Hospital will be part of the University Hospital of North Staffordshire in Stoke-on-Trent while Cannock Hospital will become part of the Royal Wolverhampton Trust.
The proposals include:
- Stafford Hospital losing its maternity unit but keeping its accident and emergency department, which will continue to open from 08:00 to 22:00, as it has since December 2011
- Downgrading Stafford's critical care unit and losing some emergency surgery
- No longer admitting seriously ill children to Stafford. They will instead go to Stoke-on-Trent
- Both Cannock and Stafford hospitals will gain some minor operations and more patients will be sent to both to recover from complicated surgery
- Introducing a "Frail Elderly Assessment service", which would mean different sources providing information on older people's needs when they are referred to hospital
The proposals will now go to a public consultation, which will end on 1 October.
End Quote Dr Hugo Mascie-Taylor Trust Special AdministratorIt was not long ago that people in this town thought they were going to lose their hospital"
They will then go to health regulator Monitor before going to the Health Secretary to make the final decision by the end of the year.
If approved, the proposals will be implemented by 2018.
The Mid Staffordshire NHS Trust provided healthcare for people in Stafford, Cannock, Rugeley and the surrounding areas, covering a total population of about 276,500 people.
'Become unsafe'In April up to 50,000 people took part in a march from Stafford's town centre to the hospital, protesting at plans to downgrade Stafford's services.
A similar number of people also signed a petition which was sent to ministers calling for the hospital not to lose any of its services.
Support Stafford Hospital campaigners have also tied hundreds of blue ribbons to lamp-posts, bollards and trees in the town to highlight their campaign.
The administrators said they did not believe other local hospitals would be able to cope with the extra pressure if Stafford's accident and emergency department was completely shut.
All existing services provided at Cannock Chase Hospital will continue with the aim of extending them where possible, the TSA said.
Administrator Alan Bloom said: "We are doing this because services will become unsafe if no changes are made."
"We have looked to provide high quality safe services, to provide them as near to patients' homes as possible without incurring the significant financial problems that have been part of the problem to date.
"We are determined not to shift the clinical or financial problems from one place to another."
'Paying the price'Fellow administrator Dr Hugo Mascie-Taylor said: "My message [to the people of Stafford] would be to look at the whole package.
"It was not long ago that people in this town thought they were going to lose their hospital. We have brought together a package of changes that financially are far more robust."
The administrators' report said the trust "cost far too much to run compared to the income it receives".
It said an overspend of £20m was predicted for 2013-14 and if "capital costs, for example, equipment is included, the funding needed will rise to £36m".
Rowan Draper, from the Support Stafford Hospital campaign, said there had been some "obvious proposals" such as dissolving the trust, but it was "very disappointing" the maternity and paediatric units would be going.
He said: "After the Francis Inquiry and other reports I have read, at no stage were they to do with the issues.
"But now expectant mothers and babies are paying the price for bad management."
Campaigners had also been fighting to stop Cannock Hospital from closing after the health trust went into administration.
Cannock MP Aidan Burley said it was "good news" the hospital in his constituency had been saved.
The Conservative MP added: "It represents a victory for all of us who campaigned to keep it open and for it to be properly managed and more fully utilised."
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