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GPs are being told not to refer patients to A&Es in the latest indication of the “significant pressure” on London hospitals this winter, the Standard can reveal.

An alert was sent on Tuesday to family doctors across north west London that St Mary’s hospital, in Paddington, and Charing Cross, in Fulham, were near capacity.

Emergency ambulances were still being accepted but hospital managers wanted to stem the flow of the “walking wounded” to keep the A&Es safe.

Official statistics revealed today that three London trusts ran out of beds on November 30 – classed by the NHS as the first official day of winter – and five were fully occupied on the first weekend in December.

North Middlesex, Lewisham and Greenwich, and Croydon said every one of their available beds was occupied on November 30, amid major shortages across the capital.

Over the weekend of December 4-6, Croydon had 14 beds spare but three more trusts had 100 per cent occupancy: London North West Healthcare (which runs Northwick Park and Ealing hospitals), Hillingdon and Imperial College Healthcare (which runs St Mary’s and Charing Cross). A trust breakdown is below.

Winter bed occupancy in London, December 2015

Joselyn King, GP engagement manager at Imperial College Healthcare Trust, told GPs in an email: “Along with other hospitals across north west London, we currently have a very large number of patients in our emergency departments. This is putting significant pressure on services across the trust.

“Both A&Es at St Mary’s and Charing Cross hospitals remain open to blue-light services. However, we need to alleviate pressure on our services to ensure continued high quality care for all.

“We are asking GPs to do all they can to help care for patients locally and not refer patients into A&E and urgent services today (Tuesday 8 December) unless it is absolutely essential.”

Sources told the Standard that Imperial was not the only London trust to appeal to GPs not to refer patients this week. NHS England (London) said it regularly advised GPs which A&Es were at capacity and where to divert patients but refused to reveal specific information.

One morning last month it warned that Northwick Park hospital, in Harrow, was “under pressure” and asked GPs to refer patients to Ealing hospital “where clinically appropriate and geographically sensible”. Ironically, Ealing is due to lose its A&E as part of a long-term shake-up of emergency care in the area.

Dr Onkar Sahota, Labour chairman of the London Assembly health committee, said: “When A&Es resort to telling GPs to avoid sending their patients there you know there is a serious problem.

“Since nearby A&Es were closed last year, north west London has consistently missed its waiting time targets. Urging GPs not to refer patients to overstretched A&E departments simply treats the symptoms. The Government have to recognise A&Es are struggling to cope with demand as a result of their closures.”

The first official indication of how the NHS is coping with winter pressures this year was published by NHS England today. An Evening Standard survey this week found that only two of the capital’s 18 acute trusts reported hitting the four-hour waiting time target in December.

An NHS England (London) spokeswoman said: “To help manage demand across London if a hospital is particularly busy it is usual and sensible practice to look at where there is capacity elsewhere and advise the NHS of this. This helps avoid delays for patients so they can be seen and cared for as quickly as possible.”