It appears the NHS in London might get its wish on downgrading two hospitals.

Loose-lipped civil servants have let slip that the much delayed Chase Farm Hospital reconfiguration has been approved by the Independent Reconfiguration Panel.

Its report has been sitting on Andrew Lansley’s desk for sign-off since 8 July and some fancy semantic footwork around the definition of A&E will be necessary to spare the blushes of the health secretary and local MPs who have fought against the closure plan.

But it is happier news for the north central London cluster primary care trust. North Middlesex University Hospital Trust can stop worrying about its long term viability and shift services over to facilities it has already built.

If Barnet and Chase Farm Hospitals Trust is then de-merged, the way is open for an established organisation to take over Barnet Hospital. The Royal Free, perhaps?

Further east, in Essex, the feeling is that King George Hospital in Ilford will lose its A&E and consultant led maternity services as well.

But the architects of this plan, known as Health for North East London, may find the IRP only approves it with some significant caveats. Can Queen’s Hospital, the other main component of Barking, Havering and Redbridge University Hospitals Trust, cope with the overflow? The report into this is also sitting on a desk in Richmond House.

Maybe an IRP recommendation is not the only way to decide King George’s future. All but one of the national regulators are investigating the trust.

Could the idea be to force a closure on safety grounds? It worked for the downgrading of Queen Mary’s Hospital in Sidcup.