THE falling number of GPs prepared to respond to out-of-hours calls is increasing pressure on accident and emergency departments, hospital bosses have warned.

They blame a five per cent rise in the number of people seeking attention at one East Lancashire hospital casualty department on doctors refusing to work outside surgery hours.

Now bosses at the East Lancashire Hospitals NHS Trust are planning talks with three local Primary Care Trusts -- responsible for GP surgeries -- to make sure there is adequate cover for patients. The move comes just days before GP surgeries across Hyndburn and Ribble Valley change their out-of-hours service and, instead, work on a rota.

According to figures published for Burnley General Hospital, the number of people attending A&E rose from 20,676 between April and July 2003, to 21,903 in the same period this year.

The rise was not as steep at Blackburn Royal Infirmary, up from 24,126 in April to June last year, to 24,229 in the same period this year -- a rise of 0.42 per cent. Overall within the Trust, the number of people seeking help at A&E rose 2.97 per cent.

A meeting of the trust board was told much of the rise had been put down to more people turning to casualty departments because they can no longer get access to GPs easily.

Many doctors no longer offer out-of-hours services, and patients have been told to contact NHS Direct for advice first, or to ring a central number set up by several practices.

But the meeting was told that most people have either lost, or forgotten, the correct procedure and are now turning up at A&E departments instead.

The problem has been particularly acute in Burnley, Pendle and Rossendale, and GPs in Hyndburn and Ribble Valley are also following suit.

Chairman Christine Kirk said: "People need to know where to turn for things which aren't actually an emergency. We have hit the 94 per cent target for seeing people within four hours, but that target is going to get higher.

"We need to talk to the PCT to make sure people know where to go, instead of coming straight to hospital. They should call NHS Direct."

Hyndburn and Ribble Valley Primary Care Trust chief executive Mark Wilkinson said: "We need to educate the public about the new arrangements. There is one number across East Lancashire to call.

"Patients will continue to dial their GP's number, and then will get either a message to call the new number, or their call will be automatically transferred."

People should ring 08452 262626 to have their concerns assessed by NHS Direct.