The Paddington Health Campus, presently under government review, could be reduced in size from 218,000 m2 to 190,000 m2, according to the clients, the Royal Brompton & Harefield, and St Mary's NHS trusts.
This would lead to the final cost of the scheme falling to below £800m, although sources claim that it is unclear how much it will eventually cost. The scheme's budget at the end of last year was £827m.
A statement from the NHS trusts said the reduction was being considered after reviewing future healthcare needs in the area over the next decade.
The statement said: "We are looking at models of care 10 years into the future. This could lead to a reduction in the size of the scheme on the basis that we are working towards a different model of care where ambulatory care and chronic disease are better managed in community settings.
We are looking at models of care 10 years into the future
Paddington Health Campus client
"Our investigation is also taking into account changes in lengths of stay as well as morbidity and population issues."
It is understood that the government review team, which includes representatives from the Department of Health, the Treasury and the National Audit Office, is due to make its final decision on whether to press ahead with the scheme within the next month. Sources have claimed that the smaller scheme would receive backing from the review team.
The review was launched at the start of the year when the scheme's budget escalated from £360m to more than £800m.
The review comes as discussions are still being held with Chelsfield, the developer of the neighbouring Paddington Basin scheme, over whether the NHS trusts will move staff into its Point office building in Paddington Basin during the construction of the new hospital.
A statement from the trusts said: "We continue to evaluate all the options available in terms of the configuration of the site in the long term and how services are provided during construction.
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