Health bosses backed an option which allows the Chichester hospital – as well as Worthing and the Princess Royal in Haywards Heath – to keep the majority of its emergency services.

"We said we would listen to people and we have," West Sussex PCT chief executive John Wilderspin said.

"We have used accessibility as a deciding factor. We would keep as many services as we can on all three hospital sites."

But under the option, put forward by clinicians from across the county, many specialist and surgical services will still be centralised to either Chichester or Worthing, meaning patients face lengthy journeys if St Richard's is not chosen as the county's major general hospital.

Under its original plans the PCT, which is carrying out the shake-up of health services, proposed two A&Es be closed, but it has said the new agreement would be the best deal for residents.

Mr Wilderspin said it would 'ensure the majority of people can still go to their local A&E apart from those needing really specialist care who will be better supported in a hospital with more specialist care'.

The PCT's board met yesterday and backed the recommendation which Mr Wilderspin said 'will ensure health services remain local where possible and are only centralised where the benefits are clear'.

Under the option, both St Richard's and Worthing retain the ability to deal with many different types of emergencies.

This includes strokes, heart attacks, asthma attacks and broken bones.

Patients needing specialist care or emergency surgery and children needing specialist care will be transferred or taken immediately to either Chichester or Worthing – whichever is chosen as the major general hospital.

The major general hospital will also be the location of the county's consultant-led maternity unit. Two midwife-led units are also planned in West Sussex.

"These changes to health services will take up to three to five years and will only be implemented once safe alternatives are in place," Mr Wilderspin said.