Fears have resurfaced that Homerton’s A&E could be downgraded to an “urgent care centre” if proposals outlined in a radical plan about the future of the NHS in north-east London go ahead.

Some 90 mental health beds could also be moved from Homerton to Mile End which would become a “centre of excellence” covering seven boroughs, and Homerton in turn would become a non-urgent surgical centre.

And part of the St Leonard’s Hospital site in Kingsland Road could be sold-off for housing, according to the 107-page East London Healthcare Partnership Strategic Estates plan.

The document speaks about saving money and consolidating services in the eight boroughs that form the North East London (NEL) Sustainability and Transformation Plan (STP) partnership, first mooted in 2015 to save £587million.

The plan is the “first time anyone has said anything concrete about the path lab” since the company rebuilding it went bust in 2014, according to Coral Jones, a GP and honorary medical union secretary.

It details a “hub arrangement” with Barts as the main lab and Homerton as a “spoke” – meaning its capability to diagnose disease could be “greatly diminished”. Two years ago patient watchdog Healthwatch Hackney warned any downgrading of the path lab might affect the hospital’s capability to run an A&E service.

Hospital chiefs and a spokesman for the NEL STP, which has now changed its name to East London Health and Care Partnership (ELHCP), deny the Homerton could be downgraded.

“Everyone has been really vague until now and suddenly this plan is printed and it seems a lot more concrete,” said Dr Jones. “The problem is they do everything in secret and even when they release the plans it’s very woolly, saying ‘this is what we want to aim for’ – we are worried things slip through with no scrutiny and consultation.”

A spokesman for the ELHCP said consultation would be carried out if necessary.