NHS Fife has backed the business case for new £33m orthopaedic centre at Victoria Hospital in Kirkcaldy.
The preference is to move the busy service into a new purpose built centre.
The current facility, which carries out procedures such as knee and hip replacements, is the only in-patient facility still in the old tower block.
In July 2017, the board said the building was unsustainable as a long-term clinical environment, and orthopaedics needed to be moved before any repair work could start.
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The proposed new centre will have three theatres – one more than currently offered – an increase of nine beds up to 33, and one extra consultation room, bring the number up to 12.
Board members last week agreed to send a business plan to the Scottish Government for approval.
Paul Hawkins, chief executive, welcomed the plans, saying: “The whole team has done a sterling job. It came in at the money we asked for, and I am pleased to be moving forward with some of the board’s most exciting work.”
The board is hopeful that work can start on the new building in October 2020, with the centre opening in March 2022.