The performance of A&E services has been branded “fragile” after papers showed a quarter of patients had to wait more than four hours to be seen in March.

A report by Redbridge Clinical Commissioning Group (CCG) revealed just 75.6 per cent of patients were seen within four hours – well below the government’s 95pc target – across Barking, Havering and Redbridge University Hospitals Trust (BHRUT), which runs emergency departments at King George and Queen’s Hospitals.

Trust data showed a previous low in December 2014 of 76.8pc.

The report, which went before the CCG at a meeting last week, said the “fragile and below standard performance” was driven by several factos including a surge in A&E attendances of both walk-in patients and via ambulance compared to the previous year.

It also blamed staffing shortages in the emergency department, and poor performance during night shifts “related to access to senior decision making” and surges of patients in the evenings and nights.