Emergency operations in Gloucestershire could take place solely in Gloucester within the next five years.
A leaked document seen by the BBC shows the county's health bosses are considering centralising emergency surgery at one site.
Currently both Cheltenham General and Gloucestershire Royal, eight miles away in Gloucester, are used.
A spokesman said the proposals were at an early stage and no decision had yet been made.
The document shows the trust wants to reduce "clinical variation" over the next three to five years, in order to improve safety and reduce waiting times.
Specialist surgery, including breast surgery, bowel surgery and gastrointestinal surgery, could also be based at a single site.
Two thriving hospitals
Two of the county's Conservative MPs - Cotswolds MP, Geoffrey Clifton-Brown and Tewkesbury MP, Laurence Robertson - have accused the trust of secrecy in not publishing the proposals.
In an early day motion in Parliament, tabled on Thursday, they called for the trust to "disclose its report and publish the costs and benefits of combining services across Gloucestershire".
A trust spokesman said the document was meant for discussion among surgeons, and had not yet been presented to its board even as a draft proposal.
Consultant surgeon Aidan Fowler said: "This draft document has been widely circulated to colleagues within our division with a view to considering all the options that could improve pathways for our patients in the future.
"I am disappointed that it has been interpreted as if it were a statement of intention for the future direction of our division, which it is certainly not."
He said any changes would be subject to public scrutiny.
"We reiterate our commitment to retaining two thriving hospitals in Cheltenham and Gloucester," he added.
In July this year the trust made changes to the way emergency cases were treated, with Cheltenham's A&E being closed overnight, meaning ambulances take most 999 patients to Gloucester between 20:00 and 08:00.