Part of the case for closures of A+E and maternity units in South West London is based on poor performance, it has emerged.

The maternity units at the four hospitals were rated ‘weak’ in an inspection by the Healthcare Commission in 2007, below the national average, although since then hospitals including Kingston have focused on improving their ratings in time for the next inspection, expected this year.

The south-west London review is using that evidence as one reason why changes have to be made.

Meanwhile the medical director of Mayday Hospital in Croydon has denied it will lose its maternity ward, although Gavin Marsh, co-author of the review, admitted patients would be diverted from casualty to a GP-run polyclinic on the site.

The pledge raises the chances of Kingston being placed in the firing line if the 100 clinicians stick to the 18 options outlined in their internal documents.