A report into the future clinical strategy of Mid Staffordshire Foundation Trust has recommended it should no longer run a number of services.

The report, by Papworth Hospital Foundation Trust professor of cardiothoracic surgery John Wallwork, was ordered by former health secretary Andy Burnham in March to help him decide whether Mid Staffs should be de-authorised as a foundation trust.

The report was handed to the trust a few weeks ago but until now its contents have not been publicised.

It recommends moving most emergency surgery away from Mid Staffs to University Hospital of North Staffordshire Trust. It also says the trust should create a shared rota for emergency medicine with a neighbouring trust as it would “struggle to recruit and retain the required number of [accident and emergency] consultants and other skilled clinical staff”.

The findings of the independent inquiry into care at the trust between January 2005 and March 2009 described its A&E as “chronically understaffed in terms of consultants and nurses”.

The report also suggests complex obstetric cases should be referred to North Staffordshire at the earliest opportunity - a proposal that will put extra pressure on Mid Staffs in the wake of the death this month of twins who were born at its Stafford Hospital 13 weeks prematurely.

The report says: “Consideration should be given to early triage and referral of complex obstetric problems to a larger obstetric unit with, maybe, the requirement to change referral patterns at the margin of the catchment area for low risk patients to be directed to Mid Staffordshire.”

A spokesman for the local pressure group Cure the NHS was surprised Mid Staffs had not publicised the report. He said: “Why wasn’t a big fuss made of it? And should the babies have been there in the first place?”

In a statement, Mid Staffs chief executive Antony Sumara agreed that some services will need to be delivered in partnership with other hospitals or community services.

He said: “We have already started building relationships with other organisations and will be involving our patients and local communities.”

A Department of Health spokeswoman said the report had been circulated among interested parties, including Monitor, but de-authorisation was no longer an option because all trusts will become foundations.