5,000 Londoners a day visit A&E

The mounting pressure on hospital accident and emergency departments in London can be revealed today.

More than 5,000 people a day now visit London's casualty departments - up six per cent on last year.

Measures such as the NHS Direct 24-hour telephone advice line and walk-in centres for people with minor ailments were supposed to take the pressure off A&Es.

But an investigation by the Evening Standard reveals that hospital casualty departments in the capital have seen patient numbers grow.

Some have seen increases of more than 10 per cent in the numbers coming in, while the busiest department saw more than 10,000 people in a month. Newham experienced the biggest percentage rise - up more than 13 per cent.

Hospitals are not sure what lies behind the rise, but theories include the idea that A&Es are victims of their own success in reducing waiting times.

With a four-hour waiting time target - and the average wait in A&E now only a couple of hours - many who have relatively minor complaints, and were previously put off by long waits, are more likely to visit casualty departments.

Penelope Haile, a director of Newham University Hospital NHS trust, said: "Activity in our A&E department has increased as the patient experience has improved.

"Our recent results from the national patient survey of emergency de partments

showed the number of negative comments made about waiting times has more than halved in the past year."

However some hospital chiefs warn the increase in activity has a serious knock-on effect, as more people are admitted to wards and more need emergency surgery.

Hammersmith Hospitals NHS Trust has seen admissions from A&E into wards rise by a third.

A spokesman said: "Increased pressure on emergency services reduces our capacity for planned operations. While we are still meeting targets, a sudden cold snap would undoubtedly put extra pressure on the system."

According to some reports, walk-in treatment centres actually meant more people going to A&E - because more people are on the hospital site, and patients walk into A&E by mistake.

The busiest A&E in London, at Whipps Cross Hospital in Leytonstone, saw 10,028 people last month. A spokesman said: "Whipps Cross has traditionally had a very busy A&E department. There are a number of possible reasons for this. The reputation of the department has improved dramatically in the last two years.

"The trust has achieved a two star rating and a walk-in centre opened on site in April 2004, which means there is more patient flow on the hospital site, which can lead more people to attend A&E."

Some hospitals have asked their health authorities to investigate the rise, which comes in spite of the fact that the London Ambulance Service is taking fewer people to A&E.

Ambulance crews are aiming to treat patients at home where possible, or take them to a more appropriate setting. Such initiatives were designed to take the pressure off A&E departments.

A spokesman for the Department of Health said: "Patients are now more inclined to go to A&E as their first port of call as they can expect to be treated by high quality professionals to high clinical standards and they can expect to be treated far more quickly than in the past."