It would not be "clinically viable" to retain a closure-threatened A&E, a health body has concluded.
The report, created by two clinical commissioning groups (CCGs), found the Chorley and South Ribble Hospital department had persistent staff issues.
The unit has been operating on a part-time basis for over two years and spent much of 2016 completely closed.
The Local Democracy Reporting Service said there was still an option to make it a 24-hour urgent treatment centre.
The Chorley and South Ribble CCG and Greater CCG found eight options were feasible for the future of urgent and emergency care services across Central Lancashire, but some could be "difficult for some people to accept".
Each of these options would see the hospital remain open and able to stabilise any patient brought through its doors, before - if necessary - transferring them elsewhere if services are changed.
The Royal College of Emergency Medicine (RCEM) has warned that returning the A&E to a 24-hour operation would risk making existing staffing challenges worse and would "prove rapidly unsustainable and fail".
The delivery director for the reform programme, Jason Pawluk, said the RCEM's evidence was "helpful, but it is just one perspective", adding that an option to retain and enhance the A&E would also be fully explored.
A combined committee of the two CCGs will decide on 28 August whether to accept the recommendations.