STRUCTURE: A proposed merger between Ealing Hospital and North West London Hospitals Trust could see one of their three A&E units closed.

Minutes of a meeting in June show clinical directors from the north west London cluster met North West London Hospitals Trust chief excutive Fiona Wise and Penny Dash from McKinsey to discuss reconfiguration options.

The minutes said: “One accident and emergency department might close down from the existing three sites. All three sites would include urgent care centres. A site with urgent care and without an emergency department might retain general medicine and cardiology.

“One option being tested for the Central Middlesex site was for it to become a centre of excellence for outpatients providing one-stop clinics.”

Central Middlesex Hospital is part of NWLH and was recently rebuilt with a £69m PFI.

The minutes said: “Discussion centered on how the two PFIs in Brent [the other is a £21m community hospital in Willesden] could be utilised optimally from a clinical and value for money perspective. It was agreed that NHS Brent should be proactive in putting forward whole health economy proposals into the outline business case, eg future use of Willesden and any refurbishment costs required and the need to consider health and social care integration as well as acute one stop outpatient clinics.

“It was agreed that while GP commissioners could support the clinical case for reconfiguration any proposals for changes to sites need to be sustainable and should not be closed shortly after the major changes had been implemented.”