A scandal-hit hospital should be stripped of key services and the trust that runs it dissolved, administrators have recommended.
Mid Staffordshire NHS Trust was the focus of one of the biggest scandals in the history of the NHS when hundreds more people died than would normally be expected at Stafford Hospital.
The trust, which also runs Cannock Chase Hospital, went into administration in April after a report concluded it was not "clinically or financially sustainable".
Trust Special Administrators (TSAs) have now recommended a major shake-up, saying the trust is no longer viable and has severe financial problems - earning around £150 million a year but costing about £170m to run.
Stafford Hospital's A&E department should remain open between 8am and 10pm every day as at present, but maternity delivery services should close and children should no longer be admitted as inpatients to the hospital. People who need major emergency surgery should be treated at other hospitals in the region, with only minor procedures continuing at Stafford.
Administrators propose retaining a small critical care area for very ill patients, and planned elective care and day cases should also remain, including orthopaedic surgery. The report said some patients are "actively choosing" to use other hospitals and it was difficult to attract and retain enough doctors and nurses, partly due to the small size of the trust.
Healthcare currently provided at Cannock Chase Hospital should also stay as it is, according to the administrators' recommendations. They noted the NHS nationally is already moving towards a model of providing care in larger specialist centres but said their recommendations would mean 91% of Mid Staffordshire patients would still be accessing care at the hospitals.
Stafford Hospital was the focus of a major public inquiry after it was found poor care may have led to the deaths of hundreds of patients as a result of maltreatment and neglect.
The Francis Inquiry highlighted "appalling and unnecessary suffering of hundreds of people", with some patients left lying in their own faeces for days, forced to drink water from vases or given the wrong medication. That inquiry followed a 2009 investigation by the Healthcare Commission which found between 400 and 1,200 more people died at Stafford Hospital than would have been expected.
Shadow health secretary Andy Burnham said: "After all they have been through, today's verdict will feel like a kick in the teeth for the people of Stafford. Local people had a legitimate right to expect that the end result of the two Francis inquiries would be to give them a hospital which is both safe and sustainable. But whilst we welcome the decision to keep the A&E open, Jeremy Hunt's failure to prioritise turning the hospital around in recent years has led to the loss of maternity and paediatric services at Stafford, representing a significant downgrade of the hospital. This outcome will only fuel concerns that the Tory-led Government is taking the NHS backwards."