A consultation is expected to begin tomorrow on the location of London's specialist trauma and stroke centres.
Healthcare For London has proposed four major trauma centres but an expert panel decided only three hospitals - The Royal London, King's College and St George's - can reach the required standards for major trauma by 2010. One of two that should be ready by 2012 - the Royal Free and St Mary's - will be the fourth.
Plans, which were due to be approved by a joint committee of primary care trusts earlier this week, also recommend hyper-acute stroke units at Charing Cross, King's College, Northwick Park, Queen's, St George's, Princess Royal University, The Royal London and University College hospitals.
Trauma and stroke networks will be formed around each of the new specialist centres.
Hospitals that submitted applications to host hyper-acute stroke units and could have met requirements, but were rejected largely because of location, included St Thomas's, Chelsea and Westminster, Barnet and Mayday.
A draft consultation document said: "The clinical evidence behind our plans for new major trauma and stroke services is clear.
"We believe the proposals could save up to 500 lives a year and significantly reduce disability for thousands of others. No change is not an option. We are proposing to invest about£9m-£12m in new trauma networks; and over£23m in new stroke services."