No sooner were service level agreements more or less signed off by London acutes and commissioners, than reconfiguration issues reared their head.

Well, re-reared, as people have known for a while that reconfiguration delays could spell problems for other trusts preparing for hefty capacity improvement programmes.

North Middlesex University Hospital medical director Stanley Okolo has declared the trust’s continued payment for as yet unused capacity – space that will ultimately house work from Barnet and Chase Farm – could render it unviable if there is any more delay in Barnet’s reconfiguration.

Poor Barnet and Chase Farm – alone of the north central London providers, it is going to arbitration with its primary care trust cluster, over this year’s service level agreements.

In the north west London sector, commissioners’ service level agreement requests were a factor cited by Imperial in its fast changing plight. Could it merge with Chelsea and Westminster and the Royal Brompton?

Also in that sector, will North West London Hospitals consummate its proposed alliance with Ealing? And does anyone know what is happening to West Middlesex University Hospital, which has appeared on the Department of Health’s finance radar?

At least one reconfiguration seems more certain than it did last month.

The Royal National Orthopaedic Hospital Trust’s Stanmore estate is in a parlous condition, but the trust insists it will narrow its eight potential private finance initiative partners to three next month, with the blessing of NHS London and the DH.