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The 1867 Metropolitan Poor Law Act gave authority to the Poor Law Board to order the combination of unions and parishes within the metropolis to provide asylums for the sick poor other than the workhouse. The Central London Sick Asylum District comprised the Westminster and Strand Unions and the parishes of Saint Giles in the Fields and Saint George's Bloomsbury. In 1869 the parish of Saint Pancras was added. The District was dissolved in 1913.
The Cleveland Street Infirmary had been the Strand Union Infirmary. Before being taken over by the Strand Union it was the Saint Paul's Covent Garden parish workhouse. The appalling state of the wards and terrible standard of care in the Cleveland Street Infirmary was one of the factors which led to the introduction of the Metropolitan Poor Law Act. Cleveland Street runs betweeen the Euston Road and Goodge Street.
Highgate Asylum had been the Saint Pancras Union Infirmary, built in 1881. The Hendon Asylum, Colindale, was built by the Central London District between 1898-1900. It was sold in 1913 to the City of Westminster Union. In 1919 it was passed to the Metropolitan Asylums Board. It was still used as a hospital in the 1990s but is now closed.