Health bodies have been issued guidance on how to broach the subject of hospital closures with the public.
The guideline comes as sustainability and transformation plans (STPs) are being drawn up across England to meet significant cuts.
The plans will set out how services in each local region will evolve and become sustainable over the next five years.
But the plans, which are expected to be finalised next month, have been shrouded with controversy, with some saying they are used as a cover for service cuts and hospital closures.
Yesterday, Labour's shadow health secretary Diane Abbott said the STPs were "being used as a cloak for eye-watering cuts and closures of beds, units departments and whole hospitals".
The new guidance, from NHS Clinical Commissioners, which represents local health organisations called clinical commissioning groups (CCGs), set out how health officials can try to earn the confidence of the public, patients and local politicians when making changes.
The document, entitled Making Difficult Decisions, says that the most challenging decisions for commissioners are the "closing or relocating of entire services" such as A&E departments, maternity units or even a community hospital.
The document offers "top tips on making difficult decisions", including; recognising that local support is "vital" and how to "manage stakeholder perceptions through active engagement, consultation and nurturing trustworthy relationships".
The document states: "Public reaction and political sensitivities are perceived by some as the greatest barriers to re-prioritising services.
"Any plan to reconfigure, relocate or withdraw a service can be met with opposition and be perceived by the public, politicians and sometimes clinicians as detrimental to patients and based entirely on the need to cut costs.
"Some CCGs were frustrated that, while budget constraints and the austerity agenda were clearly a factor, a sound, rational case for change that would result in a safer and better service for patients sometimes can be drowned out by a local clamour."
Commenting on the guidance, Dr Amanda Doyle, co-chair of NHS Clinical Commissioners, said: "Clinical commissioners have always had to make tough decisions and prioritise how finite resources are allocated while maintaining a fair and accessible healthcare system.
"With increasing financial pressures, spiralling demand and a drive to achieve long-term sustainability and transformation this is now more the case than ever.
"This new report draws on research and the practical experience of commissioners to bring together the factors that can enable difficult decisions to be made and seen through while commanding confidence of patients and the public."