The future of a troubled hospital in Dunbartonshire has been secured, after an independent review.
NHS Greater Glasgow and Clyde (GGC) wanted to close the Vale of Leven's unscheduled admissions unit, over a shortage of anaesthetists.
The review concluded that anaesthetic services at the Vale were unsustainable.
Under the deal, now being examined by NHS GGC, some emergencies would still be transferred to Paisley or Glasgow.
But the review team suggested a compromise under which most patients could still be admitted.
It said unscheduled medical admissions should continue for patients assessed by a doctor before admission as suitable for treatment there.
Where no assessment was made, patients would be transferred to other hospitals.
Health Secretary Nicola Sturgeon said the review would offer greater clarity to the health authority when planning future service provision.
"This report clearly shows there are alternatives to closing the emergency unit which can retain vital services locally without compromising on patient safety," she said.
"It is important to emphasise no final decisions have been taken but this report will inform future work."
NHS GGC chief executive, Tom Divers, said the health board was committed to examining these proposals.
These would include plans, he said, for a new £17m primary care centre.
The conclusions of the review were given a mixed reaction by opposition parties.
Labour MSP for Dumbarton, Jackie Baillie, described it as "hugely disappointing".
"To all intents and purposes, Nicola Sturgeon has announced the closure of emergency facilities at the Vale of Leven Hospital," she said.
"Her decision is a betrayal of patients, doctors and staff.
"It means any patient who is not referred by a doctor to the Vale of Leven Hospital will have to be treated at the Royal Alexandra Infirmary in Paisley."
But the Conservative health spokesman, Jackson Carlaw, said the report was another step in the right direction.
"Coming on the back of news that the birthing unit is to be saved, I hope this marks a clean break from the Lib/Lab pact's policy of allowing Clyde services to wither on the vine," he said.
"The board should waste no time in reversing its proposed cuts and ensuring that sufficient resources are put in place to guarantee top quality care at the Vale for the long term."
The Vale lost its accident and emergency unit and consultants in the maternity ward after previous reviews.
It was also at the centre of a recent outbreak of Clostridium difficile, when nine people died and more than 50 were infected during December and June.
An independent report into the outbreak highlighted poor hygiene and management of antibiotics at the hospital.
Families of patients who died are planning to take legal action.
A copy of the report was also handed to the procurator fiscal.