The Welsh government is set to go ahead with its reconfiguration of acute services across south east and west Wales.
In a statement to the Welsh Assembly, health and social services minister Edwina Hart confirmed that the proposed mergers of acute hospitals across the region would see the creation of three new large acute hospitals in South Wales.
Pontypridd and Rhondda trust and North Glamorgan trust will merge next April with a shadow board set up to manage both organisations from this December.
The proposed merger of Swansea trust and Bro Morgannwg trust is still under consultation.
Staff and community health councils in the area will now be consulted on a proposal to create a single trust serving a population of 600,000 from next April.
A third proposed merger that would see Ceredigion and Mid Wales trust, Carmarthenshire trust, and Pembrokeshire and Derwen trust come together across South Wales will also be subject to further consultation.
Ms Hart said change was an inevitable part of improvement.
'The question before us is not whether or not to change [but] how to make that change in the most effective possible way,' she commented.