Plans for the future of maternity services in Moray require upgrades at Raigmore Hospital in Inverness, it has been announced.
Services at Dr Gray's in Elgin were downgraded in 2018 due to staff shortages, forcing most expectant mothers to travel to Aberdeen.
In March it was announced the plan was for consultant-led maternity services to return.
A new draft plan said more specialist staff in Inverness were also needed.
The plan has been submitted to the Scottish government by NHS Grampian and NHS Highland.
The health boards hope to have the upgrades completed and the new staff - midwives, consultants and nurses - in place by December 2023.
In the plan they warn of the possibility of the changes being delayed, but added that they were taking steps to avoid that from happening.
The new plan has shelved a previous pledge to provide planned caesarean sections at Dr Gray's by the end of next year.
While NHS Grampian clinical teams want to be able to offer this service, the health board said it would not be possible within the proposed timeframe.
NHS Grampian and NHS Highland said they were working together to ensure women in Moray had access to safe, high quality, fully supported maternity and neonatal services.
Health Secretary Humza Yousaf said the plan would be considered in the coming weeks.
Prof Linda De Caestecker, recently retired as director of public health at NHS Greater Glasgow and Clyde, has been asked by the government to provide additional external input and advice.
Mr Yousaf said: "I commend both boards for the ambitious timescale they have set out to achieving the Moray networked model by the end of 2023.
"It is right now to allow some time for the plan and associated documents to be scrutinised and discussed in more detail and I intend updating the Scottish Parliament as soon as is practicable at the beginning of the next session."
Moray SNP MSP Richard Lochhead said it was refreshing to be discussing the restoration of maternity services for women in the area.
Scottish Conservative leader Douglas Ross, who is the MP for Moray, attended the NHS Grampian meeting about the plans and called the situation "disgraceful".
He said: "This meeting confirmed the very worst fears of expectant mothers and myself. A full return of consultant-led services at Dr Gray's hospital may take up to a decade to return, or may never happen at all.
"The situation for expectant mothers in Moray is nothing short of a scandal, yet the health board and health secretary are simply not giving it the urgency it badly needs.
"I will continue to press for the full return of consultant-led maternity services at Dr Gray's and call on Humza Yousaf to answer my questions on behalf of expectant mothers and families in Moray as quickly as possible."
Maternity services were established at Dr Gray's in 1995 after a local campaign - but there have been difficulties in both recruiting and retaining staff over the last decade.
That led to the downgrading of services in 2018. The move was meant to be temporary, but the service has not been reinstated.
Some straightforward births still take place in Elgin, but the majority of Moray babies are delivered in Aberdeen.
The drive from Elgin to Aberdeen can take more than 90 minutes, depending on the conditions.
Last year the Scottish government commissioned a review to examine whether a consultant-led service could be reinstated.
Its report recommended setting up a community maternity unit which would mainly be linked to Raigmore.
The journey from Elgin to Inverness takes about an hour.
NHS Highland bosses previously said they had highlighted the challenges already being faced at Raigmore.
These included the need for an overhaul of the Inverness hospital's maternity department so it was fit for the future, and difficulties in recruiting and retaining staff.