In the first 21 days of January, more than 7,800 seriously ill or injured patients were treated in Northwick Park Hospital's A&E department - an average of 375 each day.
The lively A&E in Harrow receives more ambulances than any other hospital in London, with staff greeting as many as 130 in one day.
After a local NHS boss warned of "sustained pressure" at the hospital this winter, getwestlondon was invited to spend a day in the A&E department to get a taste of life on the frontline.
From the high-pressured resuscitation unit, where three patients arrived in just five minutes, to walking 8,000 steps in just four hours, here's a look at what an afternoon in A&E involves.
Arriving in A&E
On Wednesday (January 24) I was ushered into Northwick Park's A&E and welcomed by a group of friendly NHS staff, one of whom was bold enough to say the banned "Q" word ahead of a morning meeting about patient progress.
Although saying "quiet" is banned - usually prompting doctors and nurses to lunge towards a wooden surface - the department did seem relatively calm that morning.
However, I was immediately told to return in the evening, when it's not unusual to see stretcher-bound patients queueing down the corridor.
'We see a high turnover of nurses'
I was then led to the "pit stop", the first port of call for all ambulances and paramedics arriving at the hospital with seriously ill patients.
The hospital dealt with a staggering 60,000 patients who arrived by ambulance last year, yet senior sister Cathy Grimes said they now have "much more coming in compared to before".
Ms Grimes, who has worked at the hospital for seven years, said: "It's not unusual for patients to be waiting in the corridor here.
"We just don't have the number of beds to deal with the number of patients coming in.
"We see a high turnover of nurses working in A&E simply because of the pressure the role brings, paramedics often have to help with the patients coming in."
'It's either sink or swim here'
Opposite the "pit stop" desk is the fast-paced resuscitation unit, which has seven rooms used for treating trauma victims and patients with life-threatening illnesses or injuries.
Although staff try to keep one room available for incoming patients, advanced clinical practitioner in training John Ross said the rooms are often at capacity.
In my first five minutes in the resus unit, three patients arrived when only two beds were free.
"It's usually full capacity throughout the day," Mr Ross said.
"There are a lot of patients who need to be moved elsewhere, but they end up in here for quite a while, so they end up in the corridor unfortunately when we've not got space for them.
"Nobody thinks that is ideal. The hospital isn't big enough but I don't think it can be big enough for the [number of] patients that we have."
He added: "It's either sink or swim here, I love it because it's fast-paced and constantly on the go."
The team's "blue light phone", which rings whenever there is a patient on their way to the resus department, can get up to 40 calls each day.
Bed shortage across the hospital
One thing that particularly stood out was the real issue with beds in the hospital.
During a noon meeting, divisional general manager for emergency and ambulatory care Maeve O'Callaghan-Harrington said the hospital was currently short of 20 beds.
On Monday (January 22), that number reached -50/60 beds.
Northwick Park's Emergency Department at 12pm
- 55 patients in the department
- 39 patients have been treated
- 85% of the 39 patients within four hours
- Average time of 3 hours 27 minutes spent in A&E
- Current wait of 1 hour 20 mins for patients needing to see an ED doctor
- A nine-hour wait for patients needing a bed
Ms Callaghan-Harrington said: "I have worked here for 15 years and I love it, but it's the staff here who make the job, for me. They do a remarkable job day in day out.
"Overall, we're improving - the number of black breaches, when ambulances are made to wait more than an hour, are down. On Monday we had eight, but last month there was one day with 24."
'The NHS is a godsend'
First-time A&E user Ronald Matthias, of South Harrow, was brought in for dizzy spells at 7am.
After undergoing brain and CT scans, Mr Matthias said he had been "treated really well".
He said: "This is my first time in A&E since I moved here in 1964.
"Honestly, the NHS is a godsend and anyone who says otherwise needs to be schooled.
"The staff are a credit to this hospital and have made me feel comfortable throughout."
Northwick Park's Emergency Department at 2pm
- 74 patients in the department
- 56 patients have been treated
- 88% of the 56 patients within four hours
- Current wait of 2 hour 2 mins for patients needing to see an ED doctor
- A wait of 8 hours 18 mins for patients needing a bed
- Resusitation unit still at capacity, three admissions with bad chest infections
The STARRS of A&E
At 2pm I met the team for Short Term Assessment Rehabilitation and Reablement Services (STARRS).
The STARRS team, who were unanimously praised across A&E, dedicate their days to freeing up beds in the hospital by providing a range of in-home services.
It's estimated the team save around 900 beds in Northwick Park Hospital each year.
Lead physiotherapist Jignesh Patel said: "We're keeping patients safe and we're keeping them out of hospital, which is the ultimate goal."
'Sometimes I feel I can't do my 100% best'
As my time in A&E concluded, I met physician associate (PA) Hennel Agrawal, who rotates between the A&E and the Clinical Decisions Unit (CDU).
After being a PA for three years, Ms Agrawal said the hospital is dealing with "more and more people with not enough resources" and said she is feeling the pressure.
"We simply don't have enough beds and that can be so stressful. Sometimes I feel like I can't do my 100% best because of the lack of beds," she said.
"My feeling is that the NHS is the best thing our country has and it would be really sad for it not to function as well as it could be.
"I love my job, and I hope we can keep going."
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