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One of London’s four trauma hospitals will be forced to use its winter emergency “overflow” beds when the A&E is axed at a neighbouring hospital, health chiefs have admitted.

St Mary’s hospital, in Paddington, is “already at maximum utilisation” and an expansion will not be finished prior to the closure of Hammersmith hospital’s emergency department, official documents reveal.

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Imperial College NHS trust on Wednesday unanimously agreed to close the A&E at Hammersmith on September 10 – the same day that casualty services will cease at Central Middlesex hospital in Harlesden.

Trust managers admitted there were “risks” about overcrowding at St Mary’s and warned that sick patients would spend longer in an ambulance. They feared that junior doctors will leave before they can be transferred to the new department. But they insisted the changes would ensure better treatment as specialists would be available 24 hours a day at St Mary’s.

No date was set for the downgrading of the A&E at sister hospital Charing Cross but its future was placed into doubt when Imperial’s chief operating officer Steve McManus said the trust’s emergency care would be based in “one location” – St Mary’s. Ealing hospital is also due to be downgraded. See here for background on the changes.

The trust has delayed for two months an announcement on the future of Charing Cross. An urgent care centre at Hammersmith will be extended to 24-hour opening to compensate for the loss of the A&E, which is used by about 60 patients a day – of which 25 arrive by ambulance. The vast majority are expected to be taken to St Mary’s 3.3 miles away. Hammersmith will retain its heart attack centre.

Andy Slaughter, Labour MP for Hammersmith, told me:

I think it’s an extraordinary decision to nod through the closure of a major A&E department with little or no discussion. ‘The world will be watching,’ they said. I think they are right about that. This is one of the most deprived areas of London. I’m concerned about the level of care that will be available. It will be GP cover and nurse cover rather than consultant-led.

Desiree Cranenburgh, of the Save Our Hospitals campaign, said: “It’s the most deprived area and now it’s being deprived of its A&E service.”

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A spokeswoman for Imperial College Healthcare NHS Trust said: “Before the closure takes place, to ensure we always have enough trust staff in all three of our A&Es, we can redeploy existing staff from our other A&Es and use locum staff where required, using our existing contingency plans.

“In time for the closure, the current 12-hour urgent care centre at Hammersmith Hospital will be enhanced and expanded, opening 24 hours a day, seven days a week, and other hospitals locally with a major emergency department will prepare for additional patients.

“Additionally, we have extra acute beds at St Mary’s Hospital, normally used during the busy winter period to ensure we can quickly admit those patients who need inpatient care. We will be using these, if required, after the closure of Hammersmith Hospital’s emergency unit in order to ensure that we continue to provide safe care to all our patients. We already have staffing in place to care for patients in these extra beds.”

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