Nick Clegg has defended the government’s decision to downgrade two accident and emergency departments.

Speaking in the week that emergency departments at Ealing and Charing Cross hospitals were downgraded, the deputy prime minister said: “There are of course always changes in the NHS. That’s something that has always happened and will continue to happen.”

He admitted there was “always a great controversy when you make changes in the NHS”.

Asked what he thought about the Court of Appeal’s ruling earlier this week that health secretary Jeremy Hunt did not have the mandate to make cuts at Lewisham hospital, he said: “What must always guide any decision is what the clinicians judge to be the most appropriate level of service to give patients the reassurance that when they go to hospital they get the best possible care.”

Mr Clegg was speaking on a visit with his wife, Miriam Gonzalez Durantez, to Great Ormond Street Hospital’s Halloween party.