Newsroom South East reports on the casualty crisis

At Northwick Park Hospital in Harrow, a consultant at the accident and emergency department admitted to the BBC that the situation was "unacceptable".

On Sunday night there were 20 patients on trolleys awaiting a bed in a ward at Northwick Park.

At Ealing Hospital in West London, there were 17 patients on trolleys, and at the Royal Free Hospital in Hampstead, North London, there were seven.

One Northwick Park patient, Jean Ward, said that she had spent more than 16 hours on a trolley.

Patients deteriorating

Another woman - rushed to casualty with a blood clot on the brain - had spent so long on a trolley that her condition had significantly deteriorated.

Consultant John Knottenbelt: 'It's unacceptable'

Her husband told the BBC: "The pressure on the brain is so much that she is starting to lose the feeling in one side of her face."

Mr John Knottenbelt, A&E consultant, said: "It's absolutely unacceptable. Four hours is an absolute maximum - that's our target.

"Sixteen hours is no good."

The recent closure of two A&E departments in neighbouring hospitals means that Northwick Park has to cope with 30,000 more patients a year.

Morale low

Jocelyn Kain, from health service union UNISON, said that staff morale was low.

John Pope says that the hospital will cope with winter

"When patients are in A&E like that, there is a lack of privacy and there is extra pressure on staff."

The A&E department is about to undergo a �2m refurbishment as part of a nationwide government programme to revamp crumbling casualty wards.

And Northwick Park chief executive John Pope said he was confident that the flu season, which starts towards the end of October could be handled.

He said: "We have had problems this weekend. The staff are under real strain and it's hard to train them and keep them here when they are working under these conditions.