Staff shortages were blamed last year when health bosses voted in favour of a temporary overnight closure of the emergency department at Princess Royal Hospital.
It led to thousands of people joining a protest march calling for an end to the plans, and thousands more signed a petition calling for a Government-backed rescue plan.
The planned night-time closure was called off last November when Shrewsbury and Telford Hospital NHS Trust (SaTH) announced enough staff had committed to rotas.
However, a new report to the trust's board says an emergency department oversight group met earlier this month, where it was emphasised that the situation at PRH was close to the challenges faced last year.
The board asked for it to be set up to act as an 'assurance group' for addressing the improvements required by the Care Quality Commission, which last year rated the trust 'inadequate' and saw it placed in special measures.
The report says it is also intended to address other quality governance, staffing and performance issues in relation to the emergency department services.
In the report, Tony Carroll, a non-executive director of SaTH, said: "The meeting discussed the key matters for escalation to quality and safety committee and agreed to stress the ongoing demand/capacity issues, with particular concern around the availability of middle grade doctor and the resultant rota gaps.
"It was emphasised that the situation at PRH was close to the situation faced last year when the overnight closure of the PRH emergency department was considered."
Another report to the trust's board shows that 71.1 per cent of A&E patients were seen within the four-hour government waiting target in June.
The target is 95 per cent.
SaTH's board will meet at PRH tomorrow.
Hospitals bosses have said the trust has seen significant rises in demand for emergency care in its hospitals.