The permanent overnight closure of Weston-super-Mare's A&E department has been approved by NHS bosses.
Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group backed the proposals at a meeting today (1 October).
If backed by the council, Weston's A&E department will be permanently closed overnight.
Its new opening hours would be 8am-10pm, seven days a week.
Since then campaigners have been fighting for it to stay open.
Bosses also approved plans to downgrade critical care at Weston General.
People needing a certain level of critical care or emergency surgery could be transferred to Bristol if the plans get the final seal of approval by councillors.
Operating theatres would be closed overnight and patients would be transferred back to Weston after treatment to continue their recovery.
Health bosses believe the proposals will "improve safety and quality at the hospital".
They said the lack of 24/7 access to care will be "bolstered" by an increase in the number of people admitted onto hospital wards overnight. It's claimed GP services in the area will also be improved.
Dr Martin Jones, Medical Director of the CCG, said: "Despite the best efforts of skilled and committed hospital staff, the way we organise services has simply not kept up with changing health needs over the years."
The CCG recommended that specialist urgent care for children is made available seven days a week instead of five.
A new mental health crisis and recovery centre is also expected to open in the town centre in early 2020.
According to health bosses, the newly approved plans will be gradually implemented over the next two years, until April 2021.