Kingston Hospital's integrated business plan would see nearly 500 posts deleted

This plans would see 22 less consultants, 214 fewer nurses, midwives and health visitors, 55 fewer “scientific therapeutic and technical” staff and a reduction of 140 posts listed as “non-clinical”.

The briefing document, presented to NHS Richmond & Twickenham said the trust envisaged an alliance with St George’s Hospital, Tooting, where it would take lots of simple daycase patients.

It also plans to “expand” its maternity services in the medium-term and have 150 more births in 2011/12 but it admitted it had “More work to do to secure commissioner support for medium term scheme.”

The plan anticipated the commissioners’ QIPP scheme taking £13.1m out of its income in 2011/12 but planned to mitigate this down to £5.4m by growing other activity.