Four accident and emergency consultants who resigned en masse said planned changes at their hospital meant it would have "neither an A&E service nor a safe service", it has emerged.
They quit their jobs at the Alexandra Hospital in Redditch on 13 February.
However, their resignation letter has only now been published following a Freedom of Information request to the trust that runs the hospital.
It said it had published the letter to rebut suggestions they had been gagged.
A fifth A&E consultant working at the Worcestershire Royal Hospital resigned at the same time.
In a statement, the Worcestershire Acute Hospitals NHS Trust said it had "not prevented its four A&E consultants from publishing a letter outlining their reasons for leaving", adding that it had "always been happy for them to put it in the domain".
The trust also published a response from what it described as "five of its most senior clinicians".
A&E consultants who wrote the letter
- Richard Morrell
- Sarah Crawford
- Christopher Hetherington
- David Gemmell
The trust published the two letters on the same day it emerged that a review into bullying at Worcestershire hospitals will be carried out by the independent body the Good Governance Institute.
It will examine how complaints about bullying are handled and the trust's policies on whistle-blowing.
In their resignation letter, the four consultants claim successive management decisions have "undermined services".
The consultants described themselves as "battle-weary and exhausted by the continuous pressure that we have been under".
"The situation has taken a heavy toll on our personal and family lives; the stress has been unbearable at times," they said.
Alexandra Hospital, Redditch
- Opened in 1985
- 360 beds
- Serves a population of about 200,000
They said they resigned because they could no longer see a way forward to secure safe and sustainable A&E services at the Alexandra Hospital "especially whilst the current senior management and senior clinical leadership remains in place".
The future size and shape of the Alexandra Hospital has been uncertain for several years.
All four consultants have accepted jobs at Warwick Hospital because it is "a trust who are investing in their services and value their staff".
In the response letter published on the trust's website on Wednesday, the five senior clinicians said they were "disappointed" their former colleagues had not acknowledged "the serious challenges to NHS services in this area".
Five divisional medical directors who replied
- Julian Berlet - consultant anaesthetist
- Christopher Catchpole - consultant microbiologist
- Graham James - consultant oral and maxillofacial surgeon
- Anthony Scriven - consultant cardiologist
- Andrew Short - consultant paediatrician
They said that the plan to keep "a networked A&E department" at the Alexandra Hospital, linked to the A&E department in Worcester, was based upon recommendations made in a report by Sir Bruce Keogh on the future of emergency services.
"[The consultants who resigned] are, of course, entitled to express their views but it would be wrong to suggest these views are shared by all of our clinicians at the Worcestershire Acute Hospitals NHS Trust - they are not," the letter said.
The trust said it was in discussions with a number of potential partners to replace the four consultants.