DISSOLUTION of the South London Healthcare NHS Trust and the closure of Lewisham Hospital A&E are two of six recommendations published in a draft report this morning.

Matthew Kershaw was appointed to run the debt-ridden trust after it was plunged into administration in July having ended 2011 with a deficit of £69m.

And today he has recommended the trust is dissolved and other organisations should take over the management and delivery of the NHS services it provides.

He also recommends the Department of Health provides additional funds to the local NHS to cover the excess costs of the private finance initiative buildings at Queen Elizabeth Hospital, Woolwich, and the Princess Royal University Hospital, Farnborough.

A public consultation exercise is now set to take place, starting on Friday (November 2).

The full report is available for download here.

Mr Kershaw recommended:

- Improving "operational efficiency" of trust sites, including cutting the workforce.

- Developing Queen Mary's Hospital into a Bexley Health Campus, providing day case elective surgery, endoscopy and radiotherapy. It would be owned by Oxleas NHS Trust. Dartford and Gravesham NHS Trust would provide case elective surgery on an interim basis.

- Selling off "vacant and poorly utilised premises" around the Queen Mary's site and Bromley estate.

- A £20m to £25m annual payment from the Department for Health to cover the costly PFI costs which funded Queen Elizabeth Hospital and the Pru.

- Closing Lewisham Hospital A&E department with emergency care for south east London provided by King's College Hospital, St Thomas's, Queen Elizabeth and the Pru.

- Either shutting Lewisham Hospital's maternity unit or making it a standalone obstetric-led delivery facility.

- Making Lewisham Hospital an elective centre for non-complex inpatient procedures like hip and knee replacements.

- The sale of Orpington Hospital and Beckenham Beacon.

- Write-off of trust PFI debts - said to make up one-third of the overall deficit.

Organisational changes

As part of Mr Kershaw's recommendations the trust would be broken up with other organisations taking over its services.

- Queen Elizabeth and Lewisham would merge to create a new organisation.

- The Pru could be acquired by King's College Hospital NHS Foundation Trust. An alternative would see a procurement process allowing any NHS  or private sector provider to bid for its services.