Radical changes are afoot at hospitals in west London. The BBC reports on Imperial Health Trust's proposals to sell off 55% of the site at Charing Cross Hospital, moving A&E, neurosurgery, stroke and urology elsewhere, as well as selling off 45% of St Mary's and moving the Western Eye Hospital into St Mary's.
Imperial's Clinical Strategy Framework (PDF) has this to say about Charing Cross's future:
"The redevelopment of Charing Cross Hospital is intended to lead the way for a new type of hospital, providing dedicated access to a wide range of specialist planned care on an outpatient or day-case basis. This will include an elective day-case surgery centre alongside specialist assessment and treatment and care co-ordination... the hospital site will also house primary care services, diagnostics and pharmacy, transitional care and rehabilitation, and education and wellbeing services. Urgent and emergency care services appropriate to a local hospital will also be provided at Charing Cross, as well as existing mental health and cancer support services."
When it comes to A&E, we think the important part of that paragraph is "urgent and emergency care services appropriate to a local hospital". As Imperial told the BBC, "There is no proposal to close our A&E at Charing Cross Hospital. We are awaiting further guidance from NHS England to guide the development of emergency services appropriate for a local hospital". In other words, if NHS England decides a fully equipped A&E isn't suitable for what will be a local hospital primarily providing outpatient care, the A&E will go. And why would such a hospital, probably focusing on diagnostics and minor surgery, need a unit able to deal with major trauma cases anyway?
With Hammersmith's A&E downgrading to an Urgent Care Centre on 10 September, we expect St Mary's to ultimately be Imperial's only full A&E unit.
Elsewhere in west London, the Royal Marsden and Royal Brompton hospitals are embroiled in a row over the the latter's attempts to get its Fulham Road wing reclassified as suitable for residential development. That would allow a sale to property developers on the open market which could raise around £500m from such a prime site. The hospital would then use the funds for work on its Sydney Street premises. However, the Royal Marsden points out that it's had the Fulham Road site earmarked for its own expansion, building a new cancer treatment centre, and that there's no way it can compete with developers on an open market.
The Brompton says it'll build a basement at Sydney Street to make it up to the Marsden but the issue came up at a Kensington and Chelsea council meeting recently, with councillors generally supporting the Royal Marsden. The Marsden has won this round, as the Brompton's plans have gone back to the drawing board. Expect a new application in autumn.