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Kent's three main emergency hospital trusts and the ambulance service have all appealed to the public to think twice before using them as the number of Covid patients doubles.
The warning shows the full impact doctors and nurses are facing as a new wave of coronavirus patients and high levels of staff sickness take their toll.
It also coincides with reports of an oxygen shortage to treat patients with breathing difficulties.
The NHS in Kent and Medway has twice the number of Covid-positive patients receiving care in its hospitals than it did during the first wave of the pandemic.
More critical care beds have been ordered as health bosses blitz the system to try to ensure vital cancer treatment and other urgent operations can continue. But they have warned some operations may be delayed as stretched staff are deployed to other areas.
James Devine, chief executive at Medway NHS Foundation Trust which runs the Medway Maritime Hospital at Gillingham, said: "Like many other NHS hospitals, our emergency department is experiencing high numbers of attendances. Please support us by using our emergency services appropriately. If you need medical help, contact NHS 111 first. This will help us keep you safe and ensure you receive the right care in the right place at the right time.’’
Miles Scott, chief executive for Maidstone and Tunbridge Wells NHS Trust, said: "Hospitals across Kent and Medway have had to postpone routine, non-urgent operations to free staff and space to treat Covid patients. Urgent treatments, including cancer operations, will go ahead as normal so please attend your appointments as normal unless you hear from us."
He added: “We are working hard to ensure we treat as many patients as possible while ensuring we provide a safe hospital environment. However, the increase in numbers has meant difficult decisions to prioritise cases of higher urgency. Patients affected by the decision will be contacted. Those not contacted should attend appointments as normal.
“It is vital that everyone across Kent does everything they can to help slow the spread of the virus by washing their hands frequently, wearing a face covering, and following social distancing guidelines.”
Dr Rebecca Martin, chief medical officer for East Kent Hospitals which runs the Queen Elizabeth the Queen Mother Hospital in Margate, the Kent and Canterbury Hospital in Canterbury and the William Harvey Hospital at Ashford, said: “Our staff are working incredibly hard caring for more than double the number of patients who have tested positive for coronavirus than in the first wave. Our hospitals are extremely busy.
“We are still here to help patients who need us for emergency and cancer care but we are asking people to keep A&E for emergencies only and to call 111 for advice if they are not sure. If you need urgent care, NHS111 can now book a timed appointment for patients at the most appropriate service including Urgent Treatment Centres and hospital emergency departments if needed.”
Joe Garcia, South East Ambulance (SECAmb) executive director of operations, said: "We are experiencing some very busy days and are working hard to respond to patients as quickly as possible. We are prioritising our response to our most seriously ill and injured patients but we are taking longer to reach some patients.
“We urge people to only call 999 in the event of a serious or life-threatening emergency and to use 111 for non-emergencies. We have also seen a high number of calls to our 111 service which is working hard to help patients. We would remind people to also make use of 111 online at 111.nhs.uk."
He added: “If you have had to call 999 and are waiting for an ambulance, please only call us back if a patient’s condition worsens. We are very proud of our staff and thank them for their ongoing efforts and professionalism.”
Wilf Williams, the accountable officer for NHS Kent and Medway Clinical Commissioning Group which organises the area's healthcare, said: "The NHS is always busy at this time of year but the latest wave of Covid is putting all of our services under immense pressure.
"This is the hardest period we’ve seen since the start of the pandemic. We are incredibly grateful to everyone who is working very hard to manage these challenging circumstances. We have twice the number of Covid positive patients receiving care in our hospitals than we did in the first wave.
“As Covid cases in the community have risen, the number of hospital admissions has also increased and there is pressure on all of our services. Our hospitals, ambulances, A&Es, community services, 111 and GP practices are experiencing high demand so we are asking everyone who needs to use NHS services to do so wisely.
“We urge the public to play their part in stopping the spread of Covid-19 by staying at home as much as possible, social distancing, wearing masks and washing their hands. If anyone needs urgent medical help they should call 111 first.”
A spokesman for NHS Kent and Medway Clinical Commissioning Group (CCG) said: “Oxygen is vital for the treatment of Covid positive patients so we are monitoring its supply across the NHS on a daily basis. We currently have enough oxygen to treat people in Kent and Medway.”