A cash-strapped health trust has downgraded plans for a major new hospital by axeing more than 100 planned beds.
University Hospital of North Staffordshire has revised plans for the rebuilt City General Hospital in Stoke, after it ran up a deficit of £15 million.
A spokesman said the changes were in keeping with government plans to transfer some patient care out of acute hospitals and into community health centres.
The cost of the new facility is expected to fall from £390 million to £300 million and the number of beds will be 1169, rather than 1295 as originally proposed.
The new hospital will be built using the Private Finance Initiative, which involves a private consortium funding the construction in return for payments over 35 years.
Earlier this month a similar scheme to rebuild Birmingham's Queen Elizabeth Hospital at a cost of £559 million was given the green light by the Treasury.
However, the Stoke plan still requires approval from the Department of Health and the Treasury.
The main hospital block and a unit housing cancer and maternity services will be built as planned, but a block which would have contained outpatient and day-case areas is to be scrapped.
Instead, many outpatient appointments will be transferred into community settings in GP surgeries and clinics.
Reductions in planned staffing levels mean that some car parks will also be reduced in size, cutting costs further.
Antony Sumara, the hospital's chief executive, said: "The new hospital development will still be substantial and will be very impressive compared to what we have now."
Stoke MP Joan Walley (Lab Stoke North) backed the changes. She said: "It is absolutely critical now that it gets an early decision so the work can go ahead."