Forward planning, flexibility and sheer hard work have been the key to coping with a huge increase in the number of people arriving at Epsom and St Helier's accident and emergency (A&E) departments staff told this newspaper on Friday.

Following weeks of national headlines about an unprecedented crisis in A&E departments nationally, a reporter from this newspaper was finally allowed into Epsom Hospital's A&E department to meet staff and witness what is happening.

By then the pressure had eased considerably and the department seemed relatively quiet.

Were you a patient or a worker in the A+E over the past few weeks? Let us know your experience by calling 020 8722 6337.

Top doctors who have been on the front line during an exceptionally busy five week period paid tribute to staff who had gone beyond the ordinary call of duty to help ensure the situation never reached crisis point at either hospital.

From Jan 6: Epsom and St Helier Hospitals still coping despite "unprecedented" pressure on A&Es

On Friday afternoon the A&E looked little busier than normal. An elderly man lay on a bed behind a blue screen, a woman waited for an x-ray and another patient was wheeled in on a stretcher while nurses and doctors tended to other people on the ward.

There were also spare beds in the department - something that has not always been the case over the past few weeks and has led to the cancellation of some routine operations.

From December 24: Epsom and St Helier A&E departments cope with "unprecedented surge" patients

Dr Annali Lawrenson, emergency department consultant at the trust, explained what had been done to avert a crisis.

Having enough staff in the right places had been essential - a situation made more difficult by a flu-like virus which had not only added to the number of people coming through the doors but had been affecting medical staff.

Your Local Guardian:

A+E nurse Michelle Carter and James Andren (below)

Your Local Guardian:

In addition to filling the holes with agency staff, doctors and nurses had stayed at work longer than their contracted hours to ensure the department always coped.

And extra staff had been brought in to work in key areas, such as resuscitation and paediatrics - part of a response plan drawn up before the winter pressure started to bite.

Number crunching: In the first two weeks of December 5,958 patients visited the A&E departments at Epsom and St Helier Hospitals - an 11 per cent increase compared to the same period last year.

Dr Lawrenson said a "particularly virulent flu bug" had meant elderly, asthmatic and emphysema patients had come in with chest infections and needed admission.

She said: "I think it has put a lot of pressure on the respiratory teams. But because we were prepared and had this plan...it made a big difference."

Dr Lawrenson said: "What it doesn't always do is help with finding places to admit them to, but I think that's a national problem."

Although it took longer to find a bed for patients, she said everyone was seen, cared for and given the right treatment in much the same time as usual.

Beds were made available in "day case" areas when necessary and she said: "That's had an unfortunate impact on some patients having operations cancelled but I'm sure they understand when there is a very sick patient who needs a bed."

Number crunching: In the week ending January 11 the A&E departments saw 93.2 per cent of patients within four hours, up from 89.4 per cent in the previous week. The Government target is 95 per cent.

The clinical commissioning groups also helped to free up beds in the hospitals by finding nursing home places, providing carers or nurses at home and organising treatment such as IV at home.

On Monday, January 5, the trust decided the situation had become a "business continuity incident", which meant special arrangements were needed to maintain critical services.

But it fared better than nearby hospitals such as Croydon University Hospital which declared a "major internal incident" and Ashford and St Peter's Hospitals Trust which declared a "major incident".

Asked about knock-on effects on the two A&E departments when neighbouring hospitals are full and declare a major incident, the trust's medical director and consultant paediatrician Dr Ruth Charlton said: "It does have effects and has effects across the whole hospital.

"It may change the patients ambulances are bringing into you because if a hospital is on a major incident alert then the ambulance crew will reallocate and reprioritise where patients go.

"It may affect where patients chose to go. But it also has more subtle effects. For example if a hospital has a major incident, transport to get patients home from hospital gets diverted.

"But we do really work closely with hospitals across the whole region."

She thanked staff for their dedication and said managers also worked immensely hard to co-ordinate the response in the hospital together with NHS England, healthcare commissioners and GPs.

Your Local Guardian:

Epsom A+E staff pictured in August 2014

From January 12: Hospital admin staff help hard-pressed doctors on A&E wards

She said: "The industry that sits behind what's happening in A&E that monitors how hospitals are functioning is completely unknown and unrecognised."

Dr Charlton said: "Our staff have worked so hard over the last five weeks, we have to pay respect to their dedication and the hard work and commitment and the fact they have been so flexible."

Dr Lawrenson said: "Frequently they stay on over their allotted time, but it's not a requirement. They are handing over or they want to finish off the job they are doing."

Over the Christmas and New Year period the hospitals have not just seen more patients in A&E, but more people have been admitted and stayed in hospital longer.

Dr Charlton said: "Patients coming though our doors have been particularly sick and have needed our care and attention."

She added: "It inevitably has had the result that our departments have been busy and some people with less serious conditions have had to wait a little longer."

But she said the number of patients had returned to normal over the past couple of days .

From August 2014: Epsom and St Helier hospitals A&Es top in London for urgent care target last month

-------------- Michelle Carter, an emergency nurse practitioner on duty, said: "We get a lot more walking wounded coming in especially with the wet weather particularly the elderly.

"I do think over this last week it's been much, much better in A&E and I'm sure all this news about people staying away unless really necessary has had a huge impact."

There have also been flu-like illnesses going around among staff. She said: "You can have staff shortages, but then I think a lot of staff have been working extra hours themselves."

-------- Jakub Kudajczyk, 31, who had waited about an hour and a half, said he came into A&E after he could not sleep because of pain in his knee.

Mr Kudajczyk said: "I have noticed over the course of the past couple of weeks mention in the news of A&Es being choker block.

"I did worry that maybe today was not the best time to come in, but actually it's been amazing service and I got seen a lot quicker than expected."

------- Janet Giovinazzo, 67, from Epsom, fell down the stairs, twisted her knee, came into A&E and waited about an hour and a half.

Mrs Giovinazzo said: "They have always been as quick as they can. They can only do what they can do. The evening is different, this is during the day."

When asked if staff seemed under pressure, she said: "No more than normal. They are understaffed obviously, as is everywhere. That's where the money needs to go - staffing."

------- Dennis Hayler brought his son with a high temperature to children's A&E, saw the triage nurse within 10 minutes and saw the doctor 30 minutes later on the night of Sunday, January 11.

Mr Hayler said: "It was quiet. They were very helpful and courteous.

They help children to relax and put them at ease.

"I think they do a good job, especially compared to St Peter's which is much bigger. I have waited with my mother four to five hours there."