PART THREE The Campus partners were unable to agree a deliverable scheme

3.1  The Royal Brompton and Harefield NHS Trust Board decided in May 2005 that it could not recommend the Addendum to a new OBC to replace the 2000 OBC unless and until three concerns were addressed to its satisfaction. The concerns were:

■  the current absence of certainty about a suitable land deal and its acceptability;

■  the affordability gap for the Campus and in particular for St Mary's NHS Trust under the Payment by Results regime, after transitional funding has ceased, with potentially serious implications for the strategic coherence and original vision of the Campus; and

■  the work being undertaken in north west London towards improving efficiency of service delivery raises fundamental issues about the capacity and configuration of services in the sector with further potential implications for the Campus as originally envisaged.

This part of the report considers the build-up of these problems.