The first decision to downgrade an accident and emergency department since the coalition government was elected is due to be taken by NHS Nottinghamshire County tomorrow.

The PCT board is being recommended to replace the A&E at Newark Hospital with a service that will not take medical admissions or emergencies.

Under the plans, a staff grade doctor or clinical fellow will provide medical cover during the day, with a GP covering out of hours work alongside nurse practitioners, according to Sherwood Forest Hospitals Foundation trust, which runs the hospitals. “Blue light” patients will be taken to alternative hospitals, mainly Lincoln.

Health secretary Andrew Lansley has said reconfiguration proposals need to meet strengthened criteria with local communities - including the public and GPs - determining the shape of local services.

PCT director of communications and engagement Matt Youdale said: “We are very confident that when the Department of Health  looks at the detail and at the rationale they will see it as the right thing to do. It is about patient safety.”

The PCT argues the existing unit cannot continue as it is, with no intensive care beds or access to 24 hour emergency surgery on site. Around 1,600 patients a year are already transferred to other hospital trusts, including Sherwood Forest.

It says both clinicians and the public support the proposal for a 24 hour service - it is dropping an option of closing the unit overnight which the hospital trust opposed - and the public will benefit from an enhanced GP out of hours service, based at the hospital.

But Dr Ian Campbell, chair of the Save Newark Hospital Campaign and Labour candidate for Newark at the election, said: “The public were not given adequate choice - it was a choice between reducing the A&E department to a minor injuries unit or a minor injuries unit.

“Everything that happens is flying in the face of what Andrew Lansley has said about a clear choice for the public.”

Campaigners to “save” the hospital have collected some 14,000 signatures to various petitions against the proposed changes.