There was mayhem there - when you looked at the waiting room, it was like watching a crowd waiting to get into a football match

Ian Knowles, relative

The relatives of John Knowles, who had suffered rib injuries in falls at his home in Edgware, say that the closure of another casualty department nearby has placed Northwick Park under "incredible pressure".

The survey, conducted by the local community health council, placed Northwick Park top of a "league table" of long-wait hospitals.

Across the whole of London and the south-east of England, the hospital had 12 of the 60 longest waits found, as well as the second longest single wait.

The patients found at Northwick Park included:

• A 73-year-old man waiting 29 hours 50 minutes suffering from renal colic.
• A 42-year-old woman with chest pains who had spent 27 hours in casualty, but was about to go home as no bed was available.
• 86-year-old suffering from pneumonia waiting 23 hours 21 mins for a bed.
• 85-year-old woman waiting on a trolley for 22 hours 21 minutes awaiting admission after a fall
• 71-year-old woman waiting 22 hours 15 mins for a bed after suffering a fit.

Mr Knowles' son Ian told BBC News Online that his father had been taken into Northwick Park on Sunday evening.

He said: "There was mayhem there - when you looked at the waiting room, it was like watching a crowd waiting to get into a football match.

"The staff were obviously doing their best under enormous pressure, but there were simply too many people. It's horrific."

The A&E department at Northwick Park has been exceptionally busy in the past week

Northwick Park Hospital spokesman

The hospital said that the 93-year-old had not needed a bed, and had only been kept in casualty overnight because he was living alone - although he was eventually admitted the following day.

A spokesman said: "The A&E department at Northwick Park has been exceptionally busy in the past week.

"The trust recognises that A&E is not the most appropriate environment for an overnight stay and apologises for any distress caused.

"However, we have to prioritise those in the greatest need of treatment."

Northwick Park is notorious for long waiting times in casualty - in February 2000, a 71-year-old woman with a broken pubic bone was found to have been waiting 40 hours.

During one busy weekend last year, 20 patients were estimated to be waiting on trolleys in the department for beds to be found, a situation described as "unacceptable" by an A&E consultant.

There simply are not enough facilities in this part of London to help people

A&E consultant

"There simply are not enough facilities in this part of London to help people."

The trust has introduced several measures to try to cut casualty waits, including a medical discharge lounge to free up ward beds more quickly, and an alert system to make sure doctors know if waiting times are increasing.

The government has pledged, as part of their "NHS Plan", to cut waiting times in casualty departments to no more than four hours.

However, the random inspections by community health councils - which could be abolished by the government - regularly reveal far longer waits than these.