EAST Lancashire’s hospital boss has told the GP who criticised her under fire A&E department: You’re bang out of order.

And Marie Burnham said GPs had put extra pressure on services by sending too many patients their way — and called on community health trusts to stump up more cash to ease bed shortages.

The chief executive of East Lancashire Hospitals NHS Trust hit back after Barrowford GP Dr Iain Ashworth told the Lancashire Telegraph that patients were being discharged “dangerously early” to free up beds.

It followed a row over the unprecedented number of patients turning up at A&E.

Earlier this month the volume of patients forced the emergency department at the Royal Blackburn Hospital to be closed for three hours.

Patients were sent up to 28 miles away for treatment.

Miss Burnham admitted wards were “stuffed to the gills”, but denied patients were being put at risk.

She accused some doctors of referring patients to hospital when they were terminally ill and would get better end-of-life care at home, as well as delaying referrals until patients were so ill they needed long stays in hospital.

Miss Burnham said: “Of course I am concerned about capacity, but all that will be achieved by GPs like him speaking out in this way is an undermining of public confidence in my hospitals, which consistently provide excellent-quality care when under enormous pressure.

“That’s bang out of order.

“I am not prepared to accept that my staff and trust should continue to be criticised in this way, when the solution to the current problems we are facing depends on the Primary Care Trust’s funding additional beds, which I am confident they will do.”

The PCTs, NHS East Lancashire and NHS Blackburn with Darwen, oversee GPs’ contracts, provide community care, and pay for every patient who visits hospital.

They have already given the hospitals an extra £900,000 this year in one-off payments to help increase capacity.

But with a 14 per cent increase in emergency visits in the last two years, meetings are now being held to secure even more cash.

Miss Burnham said: “Had the PCTs not agreed that one-off support, I would have been saying to the public that we cannot cope.

“I am furious with Dr Ashworth. Not because he said we were stuffed to the gills, but because he has said it affected patient safety. I would never compromise our patients.”

Hospitals trust medical director Rineke Schram added: “People are pulling out all the stops to respond to the pressure and they are doing an incredible job.

"Dr Ashworth’s comments are a slap in the face from someone who has not even bothered to come to us with his concerns.

“It is a primary care responsibility to ensure the appropriate post-operative care is available, and the same goes for patients who have terminal diseases, who are usually happier being cared for at home as they near the end of their lives.”

Miss Burnham stressed that PCT support had been instrumental to introducing measures including a 25-bed overspill ward at Royal Blackburn Hospital, recruiting more staff, adding more ambulances, and a dedicated waiting area for discharged patients.

She said the ‘explosion’ in patient numbers had been seen at hospitals throughout the country, and had not been predicted by health experts.

Dr Ashworth said: “There is not enough infrastructure in the community to look after these people.

“We would all like people to be able to recover at home, but the hospitals shake-up was pushed through on political imperative, with no real planning for what would happen to the patients.

"We try not to send people to hospital if we can help it, because we know there are no beds."