A leading north London hospital could lose its maternity unit, if plans being considered by health bosses go ahead.

The number of neonatal and maternity hospitals in north central London could be shrunk from five to four, as part of plans as part of NHS North London Integrated Care Board since November 2021.

The favoured option would be to offer a home birth service, a unit able to support premature and very ill babies, a labour ward led by a consultant obstetrician and a midwife-led birth unit at four units.

These would be University College London Hospital (UCLH), Barnet Hospital, North Mid and Whittington Health in Archway - meaning the closure of the service at Hampstead's Royal Free Hospital.

This is seen as easier than the second option - to keep services at UCLH, Barnet Hospital, North Mid and the Royal Free Hospital and close the unit at Whittington Health.

This is because because Whittington Hospital already has a unit for premature and very ill babies while the Royal Free Hospital currently has a special care unit, making keeping the service at the Whittington "a smoother transition" with "minimal" need for staffing changes.

Both options would mean closing all maternity and newborn baby services at one hospital.

The care board, which includes NHS trusts and councils, says clinicians, including doctors, midwives and other healthcare professionals, have led the design of the proposals with input from parents, patients and families.

It claims that more than 500 staff, patients and members of the public have shared their views on the programmes findings to date and over 75% of people agreed or strongly agreed with the opportunities for how these services could be improved.

The board's chief medical officer Jo Sauvage said: “While NHS front-line staff work incredibly hard to deliver good quality maternity, neonatal and paediatric surgical care, services aren’t currently set up in the best way to meet the changing needs of local people.

"Fewer babies are being born in North Central London and more complex care is often needed during pregnancy and birth, and we need to adapt our services to that. Our goal is to align services with the changing needs of the community and continually evolving best practice."

The board has projected 850 deliveries per year to hospitals in north west London, which its integrated care board has confirmed could be delivered within existing capacity, while closing the Whittington Unit would make patient flow to north east London more difficult to manage.

It says either proposed option would require "significant" additional investment - of around £40 million - to improve, expand and modernise the remaining hospitals.

Some surgery for or babies and very young children, and some complex or rare surgery for older children could also be moved to "a centre of expertise" for emergency and inpatient surgery at Great Ormond Street Hospital and a centre of expertise for day case surgery at University College London Hospitals.

There are separate recommendations to consult on a proposed option to close the birth suites at Edgware Birth Centre, but keep ante and post-natal services open.

This is because the site is not well used, with only 45 of the 20,000 births in north central London in 2021/22 taking place there and the number declining since 2017. 

The proposed options and a recommendation to go out to widespread public consultation with patients, staff and the public will be considered next week by North Central London ICB's Board of Members.

If approved, recommendations include starting a 14-week public consultation on 11 December 2023 to gather views on the proposed options.

A final decision is expected over the autumn or winter of 2024/25.