• Specialist and teaching trusts to merge as part of NHSE plan to transform cardio-respiratory services in London
  • Royal Brompton to move to Westminster Bridge, and merge with Guy’s and St Thomas’
  • Plans had been opposed by Imperial, and Chelsea and Westminster

A prestigious specialist trust will merge with one of the capital’s biggest teaching hospital trusts, in a deal which could pave the way for a huge land sale in west London.

NHS England agreed a plan at its January board meeting that will allow the Royal Brompton and Harefield Foundation Trust to merge with Guy’s and St Thomas’ FT, potentially by April 2021. Board members stressed the complexities involved in enabling the deal, and said NHSE chief executive Sir Simon Stevens had been closely involved.

The plan also involves relocating all services from the Royal Brompton’s main site in Chelsea to Guy’s Westminster Bridge site, which was opposed by Imperial College Healthcare Trust and Chelsea and Westminster Hospital FT.

The merger was first planned in 2017 when it became clear the Royal Brompton would have to move its paediatric congenital heart disease service to comply with new NHSE clinical standards.

It developed a plan to move both its adult and child CHD services to GSTT’s Westminster Bridge site so the paediatric service could be colocated with the south London trust’s Evelina London Children’s Hospital, making it compliant with the new standards.

However, doing so meant the trust would no longer be “sustainable financially as an organisation on its current footprint,” according to the NHSE board paper.

The Royal Brompton site is thought to be among those identified by Sir Robert Naylor as having a potential price tag of more than £1bn, if sold to housing developers.

Although accepting that paediatric heart surgery should move to Westminster Bridge, Imperial and Chelsea and Westminster had argued the rest of the Royal Brompton’s services should be split between other sites north of the river

At the NHSE board meeting, Lord Darzi, a surgeon and professor at Imperial Healthcare Trust — who had previously been strongly opposed to moving the Royal Brompton to GSTT — said: “These types of changes, reconfigurations are always very difficult, very hostile…. [Sir Simon] single handedly brought all the stakeholders together.”

NHSE’s plan sets out a means to ensure the specialist support continues to secondary care providers in north west London, including to Chelsea and Westminster FT’s high dependency unit.

A clinical transformation board will come up with “detailed service plans” to “either ensure the same support after any move or, that alternative equivalent clinical support is put in place”. 

NHSE’s plan will also provide capital support to redevelopment work in both south London and north west London. The centre will support plans to use “commercial development and asset sales to cover redevelopment costs” with bridging finance if needed.

Sir Simon said at the board meeting the “trusts involved have come together in a very constructive fashion in the last several months… I think we are really unblocking a lot of change which has been much discussed in London for a while now”.

There are no plans to move services from Harefield Hospital in Uxbridge.