A&E patients sleeping in cupboards In addition there has been a "real difference" in recent weeks following the introduction of the 111 hotline, which began handling calls for out-of-hours GPs in much of the country last month. The system was suspended in parts of the country amid concerns ambulance crews were being sent to treat minor maladies and growing numbers of patients were going directly to A&E units for health advice. Speaking at the Royal College of Nursing congress in Liverpool on Tuesday Janet Youd, the RCN's head of emergency care, said: "I think undoubtedly NHS 111 has had an impact on emergency departments." Delegates at the conference painted a shocking and chaotic picture of emergency departments they described as "full to overflowing." Karen Webb, RCN representative for the East of England, said cuts to social care budgets had resulted in more elderly patients visiting A&E, with waiting times in Norfolk often reaching 12 hours. It is becoming "increasingly commonplace" for patients to be moved around the hospital in the middle of the night, with some being forced to sleep in cupboards and other rooms such as catheter laboratories, she said. Some are moved so often that they become "lost in the system," meaning dedicated teams of doctors have to sweep the hospital the next morning on what they call "safari rounds" to locate missing patients. Dr Peter Carter, chief executive and general secretary of the RCN, said: "It's bad for the patient, it wastes time and it's also very concerning for relatives. Frankly it's a system that's simply not coping. "The whole thing is under strain," he added. This thing is in crisis. Patricia Marquis, RCN representative for the south east, said that in Oxford ambulance staff had begun transferring patients to trolleys or chairs and leaving them lined up in corridors in queues of up to 27. The situation is so bad that dedicated "queue nurses" have been assigned to care for the basic needs of ambulance patients in waiting rooms before they can be "triaged" and see a doctor, she said. In Cornwall the number of people attending A&E has risen by 50 per cent in the past three weeks, nurses said, meaning up to 20 ambulances have been left queueing outside hospitals for hours at a time. A spokesperson for NHS England said: "Our A&E departments are seeing increasing numbers of patients, meaning they are having to run harder just to stand still and the NHS deserves a great deal of credit because broadly speaking it has kept waiting times under control. Pilots of NHS 111 showed that on the whole it did not lead to a significant increase in either A&E or ambulance, and that ambulance dispatches are generally appropriate.