Doctors were alerted to the continuing casualty crisis once again yesterday as nurses battled under the strain of high admission numbers.

The Oxford Radcliffe Hospitals NHS Trust, which is responsible for the John Radcliffe accident and emergency department, faxed a letter to GPs across the county. It warned them that patients could be waiting for "some considerable time" after an initial assessment because the hospital was "currently full to capacity".

The trust has already started trying to solve the problems, which are caused by low staffing levels resulting in closed beds. In October, 40 beds will be set aside for GP referrals who will be able to fast-track the system to bypass the casualty department.

New staff are also being encouraged to join the trust's four hospitals, which also include Oxford's Churchill and Radcliffe Infirmary, and the Horton, Banbury.