Another hospital has been added to the list of those on the south west London and Surrey borders that could lose their accident and emergency and maternity facilities, HSJ can reveal.

The Better Services, Better Value programme, which was set up by NHS South West London to look at reconfiguring services in the area, has added Epsom Hospital in Surrey to the four that were already being considered in the exercise.

The process was suspended by NHS London in October after Ashford and St Peter’s Hospitals Foundation Trust dropped its bid to take over Epsom Hospital, part of the Epsom and St Helier University Hospitals Trust.

The programme’s recommendation that services be downgraded at St Helier saw opposition from local MPs, including then health minister Paul Burstow.

But HSJ can reveal that it has renewed its work and its remit has now been widened to include Epsom Hospital, on top of St Helier, St George’s, Kingston and Croydon hospitals.

But the clinicians advising BSBV still recommend that only three hospitals in the extended group should retain their A&E facilities and maternity centres.

Matthew Hopkins, Epsom and St Helier chief executive, said: “Our patients, as well as local people and staff, will have many questions about the new BSBV recommendations and may be concerned about what they mean for our hospitals.

“Crucially, absolutely no decisions have been made about which sites would be affected and further work needs to be done to determine whether the recommendations would work in practice.  As such, BSBV have commited, over the next four weeks, to develop their preferred proposals and will need to look at the impact they have on patient travel times, NHS staff numbers and what it would mean in terms of finances.”

He added that these were “long-term proposals, with changes not expected until 2017 at the very earliest”.

Michael Bailey, consultant urologist and medical director for the BSBV programme, said no decisions had yet been made.

In a statement released after an enquiry from HSJ, he reiterated Mr Hopkins’ points about the areas where further work was needed to evaluate the practical impact of the proposals. “What [our] programme board agreed was that this work will now be taken forward,” he added. “We do not expect to agree formal recommendations until February at the earliest and we will consult the public later this year on whatever is proposed.

“Local clinicians have been looking at how we can achieve better health services for local people and have suggested a future shape for local services, which importantly is not site-specific. We will need to look at all the options before deciding whether the clinical models are viable and what services should be provided at each hospital.”