Hospital chiefs have formally submitted their plans for a £420 million redevelopment of the Royal Sussex County Hospital in Eastern Road, Brighton.
The 5,000 pages of plans include building a new 12-storey tower block and putting a helipad on the existing Thomas Kemp Tower.
Brighton and Sussex University Hospitals NHS Trust has been working on the plans over the past few years and has won a funding pledge from the coalition government.
But it all hinges on the plans being given permission by Brighton and Hove City Council.
Duncan Selbie, chief executive of the hospital trust, hopes to have planning permission by the end of the year.
The value of the development is more than four times the cost of Brighton and Hove Albion’s new stadium in Falmer.
It is expected to create space for 360 beds as the Royal Sussex becomes a regional centre of excellence in teaching, trauma and tertiary care (known as the 3Ts).
While the original Barry building is much-loved, it was completed in 1828 and is widely regarded as unsuitable for a 21st-century hospital. The Jubilee building is only slightly newer and also needs replacing. Neither makes efficient use of what has become a cramped site.
Neighbours are due to take part in a monthly meeting of the Hospital Liaison Group on Monday evening (26 September).
Councillor Craig Turton, one of the three Labour members who represent East Brighton, chairs the liaison group.
He praised hospital bosses for maintaining a dialogue through the liaison group with people who would be affected by ten years of construction work and traffic.
He said that it was important to work out the best ways to mitigate the noise, dust and vibration that would affect people living near the site.
While the plans allow for more than 800 parking spaces, including a new 350-space underground car park, there are concerns that this will not be enough.
These are among the issues that the liaison group tries to tackle.