NHS North of England has approved plans to remove accident and emergency services and all inpatient surgery from Trafford General Hospital, known as the “birthplace of the NHS”.

A paper submitted to the strategic health authority cluster’s 12 July board meeting stated that board approval was needed due to “potential contentiousness and likely public, political and media interest” in the plans. This was because “Aneurin Bevan inaugurated the NHS at the site on 5 July 1948”.

However, the paper continued, there was now a “consensus view among clinicians” that level 3 critical care services and emergency surgical services were not clinically sustainable at the site. This meant that “accident and emergency, emergency surgery, most elective surgery” and the hospital’s paediatric observation and assessment unit were also unsustainable.

On 1 April 2012 Trafford Healthcare Trust, which previously ran the hospital, was taken over by Central Manchester University Hospitals Foundation Trust. This was primarily because the trust had been running a recurring financial deficit, which the paper said would be “eliminated as a consequence of the acquisition and the proposed reconfiguration”.

It asked the cluster to approve for public consultation plans to replace Trafford’s A&E unit with an urgent care centre from spring 2013. This would subsequently be downgraded to a nurse-led minor illness and injury unit. The hospital would become a “centre of excellence” for elective orthopaedic surgery, but all other inpatient surgery would cease at the site.

The proposed changes are expected to mean an extra 4,987 A&E attendances a year at University Hospitals of South Manchester FT’s Wythenshawe Hospital, and an extra 2,811 at CMFT’s Manchester Royal Infirmary.

“The pre-consultation business case shows a small financial deficit for both CMFT and UHSM as a consequence of the proposed changes,” the paper says. “It is assumed that the financial affordability of the proposal for both providers is for them rather than commissioners to manage.”

It adds that UHSM has called on commissioners to provide “significant additional capital investment” to help it increase capacity, arguing that Wythenshawe A&E already sees 17,000 more attendees annually than it was designed to serve.

However, it says, commissioners have agreed to “work together to avoid the need for capital investment” by ensuring ambulances deflect more emergencies to the infirmary or Salford Royal FT.

HSJ forecast in March that commissioners would propose downgrading Trafford’s A&E, as the first step in a major reconfiguration of Manchester acute services. Read our full briefing on the reconfiguration plans here.