Financially-stricken Kingston Hospital has warned its “very fragile” accident and emergency (A&E) department could crumble during the inevitable upsurge of patients during winter.

The hospital is currently under investigation by health regulator Monitor after reporting “excessive” A&E waiting times of more than four hours and a multi-million-pound financial deficit.

Interim chief executive Ann Radmore said the hospital’s A&E department was running at between 97 and 104 per cent bed occupancy, meaning there would be no space for a sudden, large influx of patients over the colder months.

The hospital has the added pressure of being placed in an area with an older population and has been seeing a large number of patients who could be seen by a GP instead.

Speaking at Richmond Council’s health scrutiny committee on Monday, Ms Radmore said: “It is very clear that the system is very fragile. If our beds are particularly busy then we will find that the whole emergency access falls down.

“We will have to make more cost reductions next year. We can’t return to a surplus next year and I can’t tell you when we will.

“All the trusts in NHS London have a deficit.”

Ms Radmore was also forced to defend herself as the best person to guide the hospital through troubled times.

In January she resigned from a £355,000-a-year post as chief executive of the London Ambulance Service (LAS) after two years when it reported the worst 999 response rates in the country.

She took up the interim Kingston job in August when chief executive Kate Grimes went on an extended period of sick leave.

Committee chairman Robert Thompson asked if Ms Radmore could provide members “with the confidence” that she was the right person for the job this week.

Ms Radmore replied: “Some quite innovative things were done [during my time in LAS].”

Kingston Hospital did report some positive news to quell neighbouring borough Richmond’s fears about performance.

The hospital’s financial department had predicted an £8.8m deficit for the year 2015 to 2016, but this has been reduced to £6.1m – £2.7m less than forecast.

Ms Radmore said this was made possible in part by employing foreign nurses, particularly from the Philippines, after the profession was added to a list of occupational shortages by Home Secretary Theresa May.

Kingston and Surbiton MP James Berry said: “Kingston Hospital does not only serve the local community, it spans five boroughs and many problems arise because people who are attending A&E don’t need to be there.

“There is pressure on them and the management have to find the best ways to handle that.”

He added Ms Radmore seemed “committed to turning the hospital around”.

Grahame Snelling from Kingston Healthwatch said: “Older people and people with chronic conditions are particularly vulnerable in this period.

“We will be working closely with the hospital in the time up to the inspection in January so we can understand exactly what their issues are.”