ACCIDENT and emergency services in Harrow and Brent may be merged in a bid to cut costs.

The move is being considered by the NW London Hospitals NHS Trust, which run Northwick Park Hospital in Harrow and the Central Middlesex in Park Royal and which is sinking deeper into the red.

Its cumulative budget deficit for the three years from 2003 to 2006 is £24.7 million.

The trust is looking at basing all its casualty services at Northwick Park, which could save it £11 million.

Services displaced to make room for an enlarged A&E department would be farmed out to other providers, both public and private.

These could include audiology, genito-urinary medicine, HIV/Aids outreach and dental services.

Northwick Park is the preferred site as the Central Middlesex does not have enough space to serve both boroughs.

The walk-in care and diagnostics service at the Central Middlesex would be transferred to another NHS provider or the independent sector, while the rest of the current casualty department would be transferred to a primary care trust or other health service provider for a mix of health and wellbeing services.

The closure of the Brent Emergency Care and Diagnostics (BECaD) unit at the Central Middlesex would mean patients facing longer journeys to Harrow.

Among other options are the creation of two district general hospitals, one in each borough, or leaving services as they are now.

Trust chief executive, Mary Wells, said: "This work is important for the long term future of our local hospital services.

"We need to plan now for the next five to ten years while we also continue to focus on redesigning our services and becoming more efficient this year."

Formal consultation on the options will start in November and run until February.