The 3-acre site was once to be developed as NoHo Square, because of its location to the north of Soho, by the Candy Brothers but stalled.
Under the new plan the big West End brownfield site will be transformed into an mixed-use community, centered on a landscaped public square containing the listed hospital chapel.
The development will consist of two 9 to 11 storey buildings for mixed use purposes.
Together they will house 291 homes, around 200,000 sq ft of offices, 20,000 sq ft of retail and restaurants.
Alex Lifschutz, director at architects Lifschutz Davidson Sandilands, said: “The new scheme for the former Middlesex Hospital site takes as its starting point the rich Edwardian context, drawing inspiration from the residential and light industrial buildings of this part of Fitzrovia.
“At the heart of the development, a new large public space forms the setting for the glorious grade II listed chapel, a community building set among trees and surrounded by residences of character and quality.”