Hospital chiefs believe it could take around two years before Redbridge’s only A&E closes, with a nearby department needing to be made bigger and more robust to cope with extra patients.

The axe has already fallen on the labour unit at King George Hospital, Barley Lane, Goodmayes, with the last births to happen there in spring. But the closure of the A&E unit is posing extra challenges.

Queen’s, in Rom Valley Way, Romford, will absorb some of the overspill patients from the Redbridge unit and come to serve a population of 700,000 – around double that of other A&Es in the region.

More resuscitation bays, six more beds in the major injury unit, and “improvements to the general flow of patients” in Queen’s A&E, were some proposals explained to a joint health and overview and scrutiny committee, according to a report this month.

Work to speed up patient discharge and free up much-needed beds for A&E patients is being worked out with those responsible, including NHS North East London and the City (NELC) and Havering Council.

But, the committee of councillors, from the north east London region, including Redbridge, remained “sceptical that A&E at Queen’s could cope with any further increase in demand, even if other parts of the hospital offered good care”.

The department is faring worse than in 2011, the trust admitted, with the unit consistently failing to meet the government’s target that 95 per cent of patients are treated within four hours.

During one fortnight in April, the trust saw 51 so-called “black breaches” in which patients needing urgent care were forced to wait in the back of ambulances.

Such was the level of concern regarding A&E, the regulatory watchdog Care Quality Commission (CQC) made it – along with maternity and other services – the focus of a much-publicised investigation.

The probe ended this summer with acknowledgement of improvements (there have no black breaches since June), but investigators continue to express fears.

A spokesman for NELC said GPs are working better together to reduce A&E admission by working more closely with social and community care providers, and cutting through “red tape”.

High-profile consultancy firm McKinsey was drafted in to troubleshoot by the trust’s commissioning body, NELC at a reputed cost of �1m.

The trust set up an extensive overhaul programme, called Reset, which the CQC commended. Early indicators were good, with a steady month-on-month improvement on the four-hour waiting targets, from 89 per cent in April to 92 per cent in July.

But last month it dropped back, after what Averil Dongworth, chief executive of Barking, Havering and Redbridge University Hospitals trust, called an “expected dip” due to bed readjustments, and is on the rise again. The CQC was cautious about the future, saying it “remained to be seen” whether the good work by the trust was sustainable.

Ms Dongworth said: “The whole of the health system needs to work together to tackle this issue. It is not something we can do on our own, and we need the support of our partners to ensure that patients can be seen as quickly as possible, in the most appropriate place.”