CENTRAL Middlesex Hospital could lose its A&E department in order to become a centre for routine surgery under the "more compelling" option for local healthcare reform.

The building in Acton Lane, Park Royal would host elective operations and outpatient services and keep its urgent care centre in order to compliment the transfer of all A&E cases, obstetrics, in-patient paediatric and emergency treatment to Northwick Park Hospital in Watford Road.

This scenario is the most radical of four described for the potential future reorganisation of hospital care being discussed as part of plans to merge The North West London Hospitals NHS Trust, which runs Central Middlesex and Northwick Park Hospitals, and Ealing Hospital NHS Trust.

It is coincidentally the one that would save any unified replacement health body the most money upfront: £48.9million.

The outline business case for amalgamation says of the fourth, most radical and popular scenario: "Changes will be needed to the facilities and resources available at Northwick Park Hospital to allow its developmenmt as the hub for robust, high quality emergency and acute care within the merged organisation.

"Central Middlesex Hospital will have a degree of spare capacity which could be used flexibly either in relation to joint working with community plus primary care, or for other healthcare use."

It would see admissions at Northwick Park Hospital for A&E, elective surgery and day surgery all rise - with an increase in the number of beds by 9 per cent to cope - but outpatient visitors fall.

The report says 85 per cent of cases presenting to Central Middlesex Hospital's A&E would be able to be dealt with by its existing urgent care centre anyway and it would take on more day surgery and elective surgery and see the number of beds drop to just 49.

The fourth option is rated by the two hospital trusts as "high or good" for clinical quality and integrated care and "medium" for strategic fit but "low or poor" for access to care, and feasibility, although overall it is described as the "more compelling" of the four scenarios considered.

However, the report says: "It is important to note that for the portion of local residents who will be affected, the improved quality of care offered will more than outweigh the inconvenience of prolongued travel times."

n What do you think? Contact chief reporter Ian Proctor at ianproctor@trinitysouth.co.uk