A plan is now in place, but much work remains to be done before the Dunedin Hospital rebuild begins, the head of the Southern District Health Board says.
Maps released on the hospital's web page revealed the main inpatient block will be built on the former Cadbury factory site.
The smaller outpatient and day surgery building will be operational in November 2023, and the main building is expected to be completed in November 2028.
The DHB said those locations could change, but that it was unlikely.
"We don't expect the fundamental layout of these components of the hospital to change. Final recommendations on the shape and dimensions of the buildings will be made by the design team," it said in a release.
DHB chief executive Chris Fleming said work was under way to address problems like traffic and the workforce, which could arise when work began.
"I'm looking forward to the day the first sledgehammer comes out in terms of changing the landscape.
"But there's absolutely a lot of work about how we configure the buildings to make sure that it's acutally fit for purpose - not for 2028 but for 2050."
The next step for the sites is expected to be concept design of the new buildings to nail down their size precise location.
The Ministry of Health is set to run a procurement process for designers for the concepts over the next three months.
Southern Partnership Group chair Pete Hodgson said the main inpatient block would likely be eight or nine storeys accessed primarily off Cumberland St.
"It will face the smaller six-storey outpatient and day surgery building across St Andrew St, and will probably be joined to it by way of a multilevel bridge. Current thinking is that there will be a large basement level car park," he said in a statement.
"It is going to be a challenging building to construct, because it will be large, complex, and strong. It must not only remain standing after a large earthquake but also be fully functional."
Mr Hodgson said the plan allowed for the historic Cadbury dairy factory to be retained, but not the street facade beyond that.
"It now seems likely that we will successfully retain the old dairy building. Everyone wants that, and we have enough room without having to push the hospital to dizzy heights.
"However, in due course we anticipate we will apply for consent to demolish the remainder of the Cadbury factory, along with existing buildings on the block to the north."