FEARS of a winter beds crisis at the John Radcliffe Hospital, Oxford, intensified with news that the county's main hospital was already full this week.

An appeal went out to GPs across Oxfordshire urging them not to send patients to the JR or the Horton Hospital, Banbury, to help ease the pressure.

The Oxford Radcliffe Hospitals NHS Trust remained insistent that its decision to close 180 beds, to help make savings of £33m, would not result in patients being turned away.

But two emails forwarded to The Oxford Times by a GP paint a worrying picture of the hospitals entering winter with "minimal capacity" as they prepare for big rises in patient numbers.

An email sent on Monday to GP practices by the Oxfordshire Primary Care Trust makes plain the seriousness of the situation.

It says: "All beds at the JR are currently full with patients being seen in Accident and Emergency resulting in a backlog of services. This situation has continued all weekend which has resulted in difficulties for community services and will be reviewed today."

A follow-up email on Tuesday appeals to doctors across Oxfordshire to help tackle the worsening situation by cutting back on the number of patients being sent to hospitals.

It warns: "The pressure on the whole system continues. ORH (Oxford Radcliffe Hospitals) have informed us there is minimal capacity at the Horton and John Radcliffe Hospital. If GPs could not send patients in, that would ease the pressure."

One of the emails says all surgical patients were having to be sent to the Horton as part of "a full county divert".

Oxfordshire GP Helen Groome said: "November seems very early to be receiving these type of emails."

Dr Groome, secretary of the Oxford Keep the NHS Public campaign, said: "We are very concerned. When we reach January and February, and the times of major pressure on emergency admissions, where will the beds be?"

With the trust having taken out 600 posts as part of its savings strategy, she questioned whether extra beds could be brought back on stream. She said: "They may find great difficulty in finding the staff to be able to do it."

She feared that hospital staff were reluctant to speak out about the real impact of the cuts, adding: "Because of the extreme level of bullying in the NHS, if people speak out they face being suspended."

Helen Peggs, spokesman for the trust, played down the significance of the alert to GPs, blaming two busy days. She said the number of beds available was monitored hourly with information sent around the system.

Ms Peggs said: "It is normal for Mondays and Tuesdays to be extremely busy. It does not indicate any additional pressure at the moment."

She said cancelled operations or a failure to meet A&E waiting time targets would be the real indicators of pressure on beds. "If the pressures occurred over more than a couple of days, the obvious thing would be to reopen beds. For the first time we have got flexibility. Patients are not being turned out. We are not refusing to take them in."

New Government figures indicate that Oxfordshire's main hospitals are on course to make savings of £33m, with the trust on track to end the year with an agreed deficit of £9m.

The trust says the deficit has been cut by shedding the cost of agency nurses, reducing patient length of stays, running more efficient operating theatres and closing between 160 and 200 beds.

Debbie Pearman, Oxford convenor for the Royal College of Nursing, feared the closure policy meant the local NHS was taking real risks as it entered its busiest time of year.

She said: "The trust has managed to find ways of getting people out of hospital much quicker. There has been a reduction in beds and everyone is now waiting to see what is going to happen."

Mark Ladbrooke, chairman of the Oxfordshire branch of the health workers union Unison, said: "It seems incredible to claim that everything is fine after all these cuts."