Maternity, accident and emergency and children’s wards could be closed or downgraded across hospitals in South West London NHS.

The Better Healthcare, Better Value review aims to find £64.5m in savings out of a £2.3bn budget and address major issues such as the lack of senior doctors working weekends and on maternity wards.

It also aims reshape the NHS in the face of rising costs and an ageing population.

The trust covers Kingston Hospital, Croydon University Hospital, St Helier in Sutton, St George’s in Tooting as well as South West London and St George’s Mental Health Trust.

One possible solution to help ensure senior doctors can be present at all times is to have more doctors in a reduced number of maternity units.

Another is to have fewer A&E services at those hospitals and fewer sites for children’s services.

Dr Howard Freeman, who is leading the review, said public opposition to reducing the number of maternity units, expressed at focus groups earlier this year, have been taken on board.

He said: “The working group in maternity has agreed to consider alternative suggestions to closing any of the four maternity units.

“One of the things we could do is provide different levels of service in different services in south-west London.”

Other alternatives put to patients include keeping the same number of maternity units which could leave some labour wards not having consultants at nights or at weekends.

The third option was to replace one or more of the maternity units with a standalone birthing centre staffed by midwives only.

Dr Freeman said: “Changing the way we deliver health services will save lives. A recent study showed over 500 deaths could be avoided in London if more senior doctors were available in hospitals at the weekend.

“The case for change lays bare the problems and local doctors and nurses are determined that the patients we see every day should be involved as we try to solve them.”

Kingston Healthwatch, the borough’s patient group, hosted a meeting in New Malden on Tuesday, November 8, for residents to hear about the possible solutions.

Kingston Hospital’s medical director Jane Wilson, chairwoman of the review group looking at maternity, told members of the audience: “Do you have fewer units and have senior doctors all the time or do you say it is better to have more units and most of the time it is OK and sometimes it wouldn’t be?”

She will use the social network Twitter on December 9 to discuss the options.

Edward Davey, Kingston and Surbiton MP, said: “I remain entirely opposed to any closures or any proposals that might be put forward that would see the maternity and A&E at Kingston Hospital closing.

“This is an absolute red line.”

Councillor Margaret Thompson, chairwoman of Kingston Council’s health scrutiny committee, said: “Whether it is a closure of a unit or moving things around just isn’t clear.”

A public consultation process is set to begin in May, with changes to be implemented before the end of 2013.

To see the case for change visit southwestlondon.nhs.

uk.