NHS chiefs have made no secret of the need to redevelop St Mary’s Hospital, which serves patients from all over north west London.

Imperial College Healthcare NHS Trust, which runs the hospital in Paddington, even states on its website that structural problems have included a ward ceiling “falling down”, and “a flood in our surgical innovation centre”.

The Trust said it has “seven to 10 years before there is an almost certain likelihood of a ‘catastrophic’ estate failure meaning we would have to close services.”

It says refurbishing the St Mary’s estate – which includes A&E, major trauma, intensive care and maternity wards – would cost in the region of £224 million. The figure represents one third of NHS England’s backlog of high-risk maintenance jobs.

But plans to transform the site, parts of which were built over 100 years ago, are gradually being drawn up. A planning application is due to be submitted to Westminster Council in late 2021 or early 2022.

It is understood that one proposal involves building a 30-storey tower with a helipad next door to the Queen Elizabeth the Queen Mother hospital building, on the east side of the estate.

This would make land on the west of the site “surplus to requirement” and eligible for sale. The Evening Standard reported in March that this would effectively work as a “land swap”, and make the entire scheme worth £1 billion.

The plans would enable St Mary’s to become “the major acute and specialist hospital for west and north west London – able to respond flexibly to future health need, threats and opportunities,” the Trust said.

However, one part of the redevelopment, a nine-storey “Triangle Building” for outpatients, was given planning permission in 2018. It will be built at the junction of Praed Street and South Wharf Road.

Great Western Developments Ltd and Sellar Property Group, which built The Shard, have been enlisted for the project.

The two companies are behind the neighbouring “Paddington Cube”, the nickname for the Paddington Square development, which includes a new Bakerloo Line station entrance.

Architects Foster and Partners have been hired to design the new hospital. The firm has recently worked on proposals to create a “two-decker” Hammersmith Bridge, and designed the British Museum.

A Trust spokesperson said: “We have been clear that, while maintaining at least the same capacity, we want to use the value in our surplus land to help fund the development. We are currently exploring a range of options for the design and layout of the new St Mary’s Hospital, which may mean a smaller site footprint, and we will be seeking wider input from all our stakeholders as this work progresses.”

Funding for the redevelopment will also come from the Government.

Before the 2019 general election, the Conservative party’s manifesto promised that 40 new hospitals would be built across England.

This caused controversy at the time, as it turned out the majority of the “new” hospitals would in fact be upgrades to existing hospitals.

Nonetheless, Prime Minister Boris Johnson confirmed in October that St Mary’s would receive government funding for a full redevelopment.

Money will also be supplied for a “floor by floor” refurbishment of Charing Cross Hospital, and a partial redevelopment of Hammersmith Hospital, which are also run by Imperial.

The Trust has so far confirmed that £5 million of its own cash has been allocated to producing a “business case” for the developments across all its sites.

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