By the time you read this, NHS London will almost certainly have signed off the Barts/Whipps Cross/Newham merger.

The full business case for the £1.1bn deal was to be presented on Tuesday afternoon. After that hurdle there is just the Department of Health’s transaction board and the Cooperation and Competition Panel’s judgement to negotiate in January.

If chief executive Peter Morris pulls off foundation trust authorisation by 2014 it will be quite a feat. Especially in comparison with north west London, where hospital trusts with a turnover of £1.5bn are not due over the line until 2015-16.

The as yet unnamed east London organisation will need transitional support of £86.5m and has many savings to make.

But NHS London says: “The financial efficiency targets for the new trust do not appear over-ambitious when compared to some other acute organisations.”

The strategic health authority is due to pay the £27m historic debt Whipps Cross has with the DH. But the trusts are still talking to the DH about getting support in dealing with the repayments on Barts’ private finance initiative, the largest in England. It surprised many when the McKinsey analysis of PFI trusts for the DH, revealed by HSJ, did not put Barts in the “needs national support” category.

Reconfiguration continues in another corner of the capital, I asked last week which of London’s three academic health science centres might approach the trusts of the south west. That was before the DH revealed plans for 14-18 academic health science networks, which are smaller in scope.

Could St George’s sit at the centre of one of these for south west London? It is up to new boss Miles Scott to decide.