PERFORMANCE: The north west London trust had to declare the standard after deciding the situation met the criteria of “unprecedented pressure on critical care and the trust beginning to require external aid for ITU patients”.

A performance report said: “A&E has struggled to manage the acuity of patients attending the department as well as peaks in activity. Whilst there has been a 3% increase in attendances we have seen a 13% increase in short stay admission under A&E.”

It said: “Overall our staff have been heroic.”