THE highest state of alert has been declared in A&E at Worcestershire Royal Hospital as staff struggle to cope with an unexpected surge in patients.

The highest level of escalation - level four - has now been declared at the site, with bed and staff resources stretched to breaking point following hundreds of unexpected attendances over the last two weeks.

Chief operating officer Stewart Messer warned that the ongoing surge is “putting pressure on the whole health system”.

Even at busy times the hospital would expect to have about 150 attendances at A&E every day.

But levels have been running consistently at about 180 a day for the last two weeks.

All hands have been ordered to the pump, with scheduled training and meetings cancelled to get as many doctors and nurses as possible on the wards until the situation is under control.

With bed space at a premium and the hospital rapidly running out of room for people to go, the acute trust is working with commissioners and health and social care teams to ensure vital beds are not blocked and patients are discharged as soon as they are medically fit.

Despite the efforts however, the situation in A&E will have knock-on effects for other patients - with Worcestershire Acute Hospitals NHS Trust warning it is “inevitable” some scheduled operations will need to be scrapped.

Mr Messer said: “Routine meetings and training are being cancelled to release additional staff resources. We are trying to minimise cancellation of elective surgery but inevitably some operations will need to be postponed and rescheduled.”

He is urging people to stay away from A&E unless it is strictly necessary.

“We encourage patients to seek advice from their GP or pharmacist and to consider the use of walk-in centres and minor injuries units, rather than attending A&E,” he said.

“The emergency department should only be receiving patients with life-threatening or critical conditions.”

The pressure is a flashback to last winter, when Worcestershire A&E departments struggled under “unprecedented” demand.

The situation became so severe that top emergency doctors from Worcestershire Acute Trust put their name to a letter to NHS top brass describing “toxic overcrowding” in A&E and warning that patient safety could no longer be guaranteed.

In response to the difficulties, Worcestershire Acute Trust was one of 53 trusts chosen by health secretary Jeremy Hunt to get extra funds to help it cope this winter - receiving £1 million out of a total pot of £250 million.