Scores of people turned up to the Future Fit decision making meeting at Harper Adams University, near Newport, on Tuesday night.
There were roars from members of the audience as the meeting began, with protestors holding up banners and demanding to be heard.
Some of the banners said that the county should keep both its A&Es.
Members of the 15-person panel, made up of representatives from Shropshire and Telford & Wrekin Clinical Commissioning Groups and independent members, appealed for calm saying it was a difficult meeting to take part in due to the disruption by some members of the public.
Following a discussion, where questions were asked in areas such as the affordability of the scheme and on workforce issues, the panel voted unanimously to place the county's emergency centre in Shrewsbury, meaning Telford's Princess Royal Hospital will take over responsibility for planned care.
The £312 million scheme will mean there will be walk-in urgent care centres at both Shrewsbury and Telford and consultant-led women and children's services will be based at Shrewsbury.
Health bosses say the decision will allow specialist doctors to treat the most serious cases on the emergency care site, which they say is proven to be safer, to provide better results for patients and reduce the amount of time people have to stay in hospital.
Watch the whole meeting on video here:
David Evans, chief officer at Telford & Wrekin CCG, said it marked the dawn of an exciting new era for the county's hospital services.
He said: "We understand that people have concerns and the numbers that attended the meeting highlights just how passionate people are about the NHS.
"However, we are equally passionate about ensuring that our patients benefit from the best NHS treatment possible and the decision we have made is vital for the future of patient care.
"Both the RSH and the PRH will continue to provide the services our patients use the most. These include outpatient appointments, midwife-led services, tests and urgent care.
“People can be assured that this is not a downgrading of services. This is all about a huge improvement in the care that patients will receive and the majority of patients are still going to be seen in their local hospital in the urgent care centre. In order for the local NHS to deliver top quality emergency care, we need all specialities on one site.”
Dr Simon Freeman, accountable officer for Shropshire CCG, said the joint committee had acted in the best interests of patients.
He said robust plans will now need to be developed that will include a phased building programme over the next five years.
Simon Wright, chief executive of The Shrewsbury and Telford Hospital NHS Trust, said he was delighted a decision had been made.
He said: “The decision means we can begin to shape the future for all of our services, which will help us to attract more staff, improve facilities for our people and develop healthcare that will benefit everyone.”
Dr Edwin Borman, medical director at Sath, which runs RSH and PRH, added: “These two re-developed hospitals will provide improved emergency care and improved planned care.
"It is important to remember that the majority of people who access our current A&Es will still be able to have treatment at their nearest hospital when the reconfiguration is complete."
But disappointment has been voiced by others who say the wrong decision was made.
Telford & Wrekin Councillor Nicola Lowery, representing the Ironbridge Gorge ward, said: “The community has delivered its verdict on the proposed future of our healthcare in Shropshire that provides compelling and substantive evidence to support the emergency site being based at the Princess Royal Hospital and I express my sincerest and profoundest regret that the views within our community were not heeded by Future Fit."
Peter Scott, mayor of Newport, said: "I'm disappointed, as is every Newport resident I have spoken to, especially those that have gone on the marches and supported option two."
Shropshire Councillor Tracey Huffer, for Ludlow East, added: “No one now believes Future Fit is the new future. All it seems to be trying to do is fix the past. Putting sticking plasters on major wounds.
“There is going to be a lot of argument about whether this is the right decision.
“The decision might fit the future of the NHS finances but it doesn’t fit the future of our county."
Anger as emotions run high
Scores of protesters turned out at the health meeting to vent their anger at the Future Fit process.
Inside the meeting there were noisy scenes as members of the public shouted out as committee members gave their views before the vote was taken.
However special buses laid on by Telford & Wrekin Council to transport residents without their own transport to the meeting were left unused. The authority’s chiefs arranged for a coach and two small buses to collect protesters from outside the council’s Darby House offices, in Lawn Central, Telford, at 5.50pm.
But by 6pm all were driven away empty from the meeting point. The meeting was held at Harper Adams University, in Edgmond near Newport a decision that some criticised for “difficult to get to”.
It is thought the forecast of sleet and snow may have been to blame for the lack of passengers attending the decision making meeting.
However, Telford & Wrekin’s council leader at Shaun Davies, said: “Good turn out considering Tuesday, snowy night. There is a live stream on the internet and most people think it’s a done deal.”