The Cowgate Clinic, officially known as the Edinburgh Access Initiative, has provided health services for the city’s homeless population from the Cowgatehead Church for decades.

However, plans have been submitted for a four-star hotel which could force the service to close and move elsewhere.

Drawn up by ICA Architects on behalf of Jansons Property, the hotel would be at the heart of a £65 million regeneration push for the A-listed India Buildings on Victoria Street and surrounded by a new entertainment destination of bars, restaurants, cafes and public space.

Under the proposals, the Cowgatehead Church is to be renovated and brought back into use as function facilities for the new hotel.

Experts have warned that moving the practice could lead to more deaths, mental illness and a soaring numbers of rough sleepers, while campaigners say it is more accommodation, and not hotels, that is needed in the area.

The Edinburgh Old Town Development Trust said the plans further threaten the viability of community life in the city centre and will have a negative impact on some of the most vulnerable members of the community.

Sean Bradley of the Trust told The Herald: “I’ve been living in the Grassmarket for 40 years and homeless people have always been here, always been our neighbours.

“Cowgate Free Church has been in social use for 100 years or more and 40 years as a health facility for the homeless.”

And he added: “There are 7,000 people living in the old town and what we need are more houses, not more hotels.”

Danny Campbell, project manager at North Edinburgh Drug and Alcohol Centre, said the clinic was an invaluable service and the “main support medically for homeless people in Edinburgh”.

He said: “They work with the most ostracised section of the population with complex problems.

“If people are not engaging with a basic level of treatment I think you will see an increase in rough sleeping and probably see an increase in drug related deaths.”

Danny Campbell said without dedicated services, some homeless people struggle to access help - with mental health services refusing to do assessments unless someone is drink or drug free, for example.

He added: “They are moving the service without a clear plan to improve it, for financial reasons, to my mind. The Old Town is now full of wine bars, cafes and boutique hotels and the Cowgate clinic’s client group don’t fit with that image.”

NHS Lothian plans to temporarily house the clinic within an existing service in Leith Street while a long-term solution is sought.

Professor Alex McMahon, a director at NHS Lothian, said: “The access practice in Edinburgh city centre, which provides GP, nursing and mental health services is split over two sites. The rented building in the Cowgate will be vacated in July, following its sale.

“It is our intention to eventually merge both facilities into one site as soon as a suitable business case is concluded, but in the meantime, services will continue to be provided as normal at the Leith Street centre, which also offers extended facilities and advice on housing and social work.”

The India Buildings development will go before the City of Edinburgh Council’s planning committee on May 25.