Primary care trusts have warned that delaying the proposed reconfiguration of hospitals in south east London could push services to breaking point.

The joint committee of primary care trusts for Bexley, Bromley, Greenwich, Lewisham and West Kent has called on the joint health overview and scrutiny committee to accept its proposals for change rather than referring them to the health secretary.

Following public consultation, the PCT committee concluded the best option for services would be to close the accident and emergency department at Queen Mary's Hospital Sidcup, and divert medical, surgical and paediatric emergencies to Queen Elizabeth Hospital, Princess Royal University Hospital, University Hospital Lewisham or Darent Valley Hospital. Urgent care at Queen Mary's would be expanded to provide a 24-hour service.

The scrutiny committee is due to meet on 10 September to consider the PCTs' response, deciding whether to support their decision or refer it to the secretary of state.

The price of delay

PCT committee chair Michael Chuter said: "No one should be under any illusion. Just as these changes will reduce the incidence of avoidable death and disability, improve the outcomes for mothers and babies and enrich the patient's experience, delaying them could have the opposite effect.

"A referral could prevent us making changes for around six months, and I am concerned that the current system won't cope for that long."

He said he had spoken to the chief executives of the south east London hospitals, who had all said delay would affect staff recruitment and retention, which could have an impact on the ability to continue to provide safe clinical services.

A document prepared for NHS London by Keith Palmer, a non-executive director of neighbouring Guy's and St Thomas' Hospital foundation trust, found the legal obligations to private finance initiative contractors would make it almost impossible to downsize hospital facilities at Lewisham, Queen Elizabeth, and Bromley.