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The head of the NHS in London has ordered an investigation into an alarming “spike” in A&E winter pressures.

Anne Rainsberry, regional director of NHS England (London), said she wanted to find out what had caused a record number of people to turn up at the capital’s 28 A&Es.

“The week before Christmas, we saw the highest level of attendances in A&E in London ever recorded – a nine per cent increase on the equivalent week [in 2013],” she said. “The week between Christmas and New Year, it was 6.5 per cent.

“Over the same period, 111 [the NHS 111 non-emergency helpline] saw a doubling of the number of calls, and the London Ambulance Service saw a 16 per cent rise. For every access point to the NHS, we are seeing an increase in demand.”

NHS weekly figures show that the 19 London trusts responsible for the capital’s 28 A&E departments handled 77,199 admissions, including those to minor injury units, in the seven days ending on December 21.

Giving evidence to a London Assembly investigation into the A&E crisis, Dr Rainsberry added: “I don’t think we anticipated we would see an increase of nine per cent in the week before Christmas.”

She said that between October and December, the London Ambulance Service had seen a 14 per cent increase in “category A” calls – the most serious emergencies that require an eight-minute response. Patients were generally older and sicker, she said.

“We are going to commission a review in London to see what we can understand about this spike we have seen,” she said.

Ms Rainsberry said London had received £117 million in winter funds, paying for 460 temporary staff and allowing extra hospital beds to be opened.

Julian Redhead, London spokesman for the College of Emergency Medicine, said: “It’s definitely not an emergency department issue. This is a whole system failure. A lot of this is to do with the exit block coming out of the hospital and the inability to discharge patients.”

Dr Redhead, a trauma consultant at St Mary’s hospital, added his voice to concern that the 111 helpline was fuelling A&E attendances.

“I sometimes wonder whether 111 should be replaced by a series of grandmothers giving advice to patients about how they could self-care,” he said.

Ms Rainsberry said a third of calls to 111 in London were queries about medication. “We are looking very carefully at what it is that people are ringing the service about, and trying to make sure we give them very quick access to what they need, so they don’t get frustrated and turn up in the A&E department.”

She said a separate report into the effect of closing the casualty units at Central Middlesex and Hammersmith hospitals was being written and would be published soon.

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