NHS England is being asked to approve a new A&E in the centre of Bristol this month.
Hospital bosses want to replace the current adult emergency department at the Bristol Royal Infirmary (BRI) with a new purpose-built facility at Marlborough Hill.
The development could cost up to £200million and would be completed in 2029.
The strategic outline case for the Marlborough Hill A&E is going to NHS England in January after hospital bosses in Bristol approved the plan in December.
Paula Clarke, executive managing director at University Hospitals Bristol and Weston, which runs the BRI, spoke about the plans at a board meeting on December 13.
She said: "The first aspect of our case for change is that very challenged adult [emergency department] environment, and that’s both in its location and its condition.
“Our estate and our location are not in any way fit for modern delivery of modern medicine.”
The NHS Trust believes that a new purpose-built medical centre on the Marlborough Hill site will allow them to better locate services next to each other.
The site, which is at the edge of the hospital complex, currently contains the pharmacy, staff residences, a multi-story car park, and the trust’s headquarters.
Ms Clarke said: “Marlborough Hill is our only site for the development of core clinical services. We are a landlocked city-centre site.”
She added that moving the adult emergency department out of its current location would allow for children’s services to be expanded.
Chair of the board Jayne Mee said: “This is point one of a 13-point process for eventually getting us, we hope, to the end of construction in March 2029.
"So it feels to me like it is time to get this one out of the blocks and start to work together to make this some form of reality.”
Should NHS England approve the case, it will then need to be approved by the Treasury, before construction can begin in April 2026.
Credit: John Wimperis, Local Democracy Reporting Service