Health chiefs yesterday outlined plans to strip services from hospitals in Chichester and Haywards Heath while keeping them in Worthing.
Bosses said they had been forced to make a "difficult decision" over where services should remain.
Samuel Underwood reveals what the changes will mean for people across West Sussex.
Worthing Hospital is to become the centre of medical services in West Sussex under proposals health bosses claim will transform health care in the county.
West Sussex Primary Care Trust (PCT) revealed it wants Worthing to be the major general hospital for the area and that cuts will be made at St Richard's Hospital, in Chichester, and at the Princess Royal Hospital, in Haywards Heath.
The trust's recommendations will be considered by its board next Wednesday and it is unlikely that they will be rejected.
Instead hospital campaigners were last night considering legal action to try to halt changes they fear will put lives at risk.
The proposals will mean that over the next three to five years, Worthing Hospital will be home to three centralised services. In-patient children's services, consultant-led maternity care and emergency surgery, such as serious injuries from road accidents, will all be based at the hospital. Anyone from West Sussex needing to use those units will be forced to travel to Worthing - or even outside the county - for urgent treatment.
St Richard's will still have maternity care, but this will be midwife-led rather than overseen by consultants.
The Chichester hospital will remain a centre for outpatient clinics and services such as day surgery, X-ray, physiotherapy and occupational therapy.
Chichester District Council leader, Myles Cullen, said he was stunned by the recommendation.
He said: "The most shocking thing of all is that the PCT appears to find it acceptable to place the residents of Chichester in danger by expecting seriously ill people to travel well over an hour to reach a major general hospital, which then might save their life."
But hardest hit was the Princess Royal, which as well as losing inpatient children's services and emergency surgery units, may also be left with no maternity unit.
It will have to compete with Crawley and Horsham to be the site of a single midwife-led maternity unit in the north of the county.
John Wilderspin, the chief executive of the PCT, said Worthing had been chosen because it provided the best access for the greatest number of people in the poorest and sickest areas.
He said: "The recommendation was made after considering a large number of issues and on the basis of which location would serve the best interests of the county as a whole.
"The decision on the recommended location has not been taken lightly. We have taken account of the views and advice of a wide range of people.
"We are confident that the model of care and the recommended location for centralised services is the best decision for local people now and into the future."
Mr Wilderspin said four key criteria - accessibility, clinical sustainability, deliverability and financial sustainability - were considered.
Stephen Cass, the chief executive of Worthing and Southlands Hospitals NHS Trust, said he was pleased at the PCT's recommendation.
He said: "We will now be working closely with our colleagues in Chichester to identify the best balance of services across the two sites to deliver high quality, patient focused health services at the most appropriate location.
"I want to reassure our patients, staff and wider public that our priority will continue to be the wellbeing of our patients.
"I would like to thank colleagues and campaigners for their support and for the work which so many put into supporting the case for the major general hospital at Worthing and Southlands."
Cat Hedger, from the Keep Worthing and Southlands Hospital campaign (Kwash), said she was thrilled but would not be completely happy until the final decision was made.
But their counterparts in Chichester faced bitter disappointment.
Abigail Rowe, from the Support St Richard's campaign, said: "We are devastated. The PCT has made the wrong decision.
"St Richard's covers 400 square miles compared with Worthing's 188, it's absolutely ludicrous to downgrade hospital services in such a huge rural area.
"It all came down to location and where they think the population would be best served but the population in Worthing is ten miles away from Brighton, which is just about to have £550 million thrown at it. Where is the sense in it?"
Mrs Rowe said the campaign would look at judicial review as a possible opportunity to appeal.
Andrew Liles, the chief executive of the Royal West Sussex NHS Trust, which runs St Richard's Hospital, said: "We are very disappointed with this decision.
"However, we will now get on with making this new model work for patients and staff by working with our colleagues in Worthing to identify the distribution of healthcare services across the two hospitals that will deliver the most effective care for the people of West Sussex.
"I want to reassure our patients, staff and wider public that our priority will continue to be the wellbeing of our patients.
"I also want to thank the public and the campaign group for the tremendous on going support they have shown the hospital."
Duncan Selbie, the chief executive of Brighton and Sussex University Hospitals, which runs the Royal Sussex County Hospital in Brighton and the Princess Royal Hospital, in Haywards Heath, said: "This decision means the Royal Sussex County Hospital will be further strengthened as the regional centre for trauma and critical care.
Alongside this we will continue to develop as one hospital on two sites to provide local acute services for the people of Brighton and Hove and Mid Sussex.
"We look forward to working even more closely with Worthing and Chichester and other hospitals in Sussex and beyond."
After the PCT board has considered the recommendation on Wednesday, their final decision will go to West Sussex's Joint Health Overview and Scrutiny Committee, which will review it on June 25.
From there, the PCT board will consider the committee's response and issue a draft timetable for its implementation to the PCT board by July 10.
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