An accident and emergency department at a hospital in Greater Manchester is to be closed, health bosses have decided.
More acute A&E cases could be sent to Fairfield Hospital
The unit at Rochdale Infirmary will be replaced with an "urgent care centre" dealing with less serious casualties.
The provisional decision was taken by a joint committee of Primary Care Trusts. It will be confirmed or rejected in December, after further consultation.
It is hoped the infirmary will become one of the UK's first "locality hospitals", with wider services.
It would mean medical, dental, mental health and social services could be provided on one site.
The decision comes just days after NHS chief executive David Nicholson unveiled plans to concentrate key health services at fewer hospitals - a plan that could include around 60 "reconfigurations".
Tim Presswood, chairman of the Healthy Futures Joint Committee that made the decision over Rochdale, said: "This provisional decision is a crucial step towards improving the way that health care is provided for the people of the north east of Greater Manchester.
"Planned change has to happen.
"Allowing services to continue the way that they are currently structured is not an option as all services are facing great pressure."
The changes, if confirmed, will take an estimated five years to come into effect.
It will mean Rochdale patients needing life-saving emergency treatment will use services at Fairfield Hospital in Bury, the Royal Oldham or North Manchester General Hospital.
The plans are part of a wider "Healthy Futures" review of services.