Family doctors are being forced to send patients to an overcrowded casualty department because of community hospital closures and social services cash cuts, says a county GP.

Dr Sandy Scott said there was nowhere but Oxford's John Radcliffe Hospital accident and emergency department to send elderly patients who often need 24-hour care and observation.

His comments follow claims by hospital managers, reported in yesterday's Oxford Mail that the hospital's casualty department could not cope because GPs were sending huge numbers of patients.

Dr Scott, of the Wychwood Surgery in west Oxfordshire, said responsibility was handed back to GPs because nursing shortages and bed closures within Oxfordshire's acute care had left it at crisis point. He said: "Where are the GP referrals to go?

Sometimes I have patients who are elderly and need observation and care for their own safety. "But access to community hospitals is difficult in my area, and social service cuts mean that home-help care is no longer available."

He added that since Burford Hospital had closed, he had not been given promised extra access to Witney Hospital.

He said: "Where are doctors meant to send their patients?

It is midsummer, there are no chest infections in sight and yet the JR is chock-a- block.

"What is likely to happen under next year's winter pressures?"

The Radcliffe Hospitals NHS Trust, which oversees Oxford's JR, Churchill and Radcliffe Infirmary, and The Horton, Banbury, is 300 nurses down out of 1,500, and has closed 100 beds.

Dr Scott said: "This means more responsibility for GPs and we have to look for our own alternatives." Oxfordshire Community Health Trust spokesman Ruth Sharrock said: "A community liaison nurse works with JR staff, identifying patients who may be suitable for admission to community hospitals.

"The community support service provides intensive nursing, occupational therapy and physiotherapy in people's homes."