Some non-emergency surgery may be postponed at Pinderfields Hospital, Wakefield, this winter to cope with seasonal pressures on the NHS.
Health bosses and staff are bracing themselves for another tough few months, with an increase in A&E visitors and people hospitalised with the flu near certainties at this time of the year.
The Mid Yorkshire NHS Hospitals Trust, which runs Pinderfields, has prepared extensively for winter, but says circumstances beyond its control could still lead to a crisis.
Speaking at a meeting of the trust's board, director of operations Trudie Davies said she was "anxious" about a "bottleneck" of patients needing treatment, but said that emergency care would be prioritised.
Planned surgery at Pontefract and Dewsbury Hospitals will also be put ahead of similar operations at Pinderfields.
Mrs Davies said: "We're going to try to protect elective surgery at Dewsbury, and at Pontefract as well.
"Last year, we didn't curtail any emergency care or treatment at all and this winter we plan to do the same.
"But it's possible some orthopaedic surgery at Pinderfields may be curtailed."
Mrs Davies said staff would be mobilised into a "slippery day mode" during particularly icy weather to make sure that people with broken bones could be seen to quickly.
But elderly patients who remain in hospital while waiting for a care home may be discharged earlier than normal this winter to stop bed-blocking.
Mrs Davies said: "One of the key reasons for patients remaining in hospital is patient choice.
"The issue might be being unable to find a care home to go to next, sometimes there might be an argument with the family over whether or not a care home is suitable.
"These choices might now need to be made somewhere else because we haven't got the capacity to care for every patient in hospital once they've finished their treatment, when we've so many patients to look after.
"It's not that they don't need care and support, but that just might not be here (in hospital) and that's a message that's sometimes quite difficult."
Trust chairman Jules Preston suggested that patients who stay in hospital longer than necessary would need to be moved on quickly.
He said: "I agree with you, that's an issue.
"You do see increasing evidence of an attitude of "We're in hospital, we can stay here."