The number of patients who attended accident and emergency wards has increased by more than a million in just one year, figures suggest.
The news comes after experts warned that emergency care system could collapse in six months as a result of rising demand.
Latest data from the Health and Social Care Information Centre show that 18,300,190 people attended A&E units in England between February 2012 and January 2013 - a rise of 1,034,802 from the previous year.
Almost two-fifths (39%) of those who were seen by A&E doctors were discharged with no follow up - meaning the patient did not require any further treatment or advice about their condition.
The number of patients who were admitted or referred on remained broadly similar, the provisional statistics suggest.
Earlier, the College of Emergency Medicine (CEM) called for “fundamental change” in the way emergency care is run, warning that A&E units are facing their biggest challenge in more than a decade as departments grapple with “unsustainable workloads” and lack of staff.
And the Foundation Trust Network, which represents more than 200 health trusts in England, warned that A&E services were in danger of collapse in six months time as a result of “huge pressure”.
Health secretary Jeremy Hunt said changes to the way out-of-hours care is provided had a “huge impact” on the services.
Mr Hunt said there was a “dramatic fall in confidence” in evening and weekend non-urgent cover since the last government changed the GP contract in 2004 to remove responsibility for out-of-hours care from family doctors.
“What we need to do is to have a very fundamental look at the way A&E departments work and in particular look at the alternatives to A&E because the government changed the GP contract in 2004 and they removed responsibility for out-of-hours care from GPs,” he told ITV Daybreak.
“That has caused a dramatic fall in confidence in the public in what their alternatives to A&E are - that is what we have to sort out.”
In an interview with BBC Breakfast, Mr Hunt said since the contract was changed there were now four million more people visiting A&E departments every year.
“I think one of the problems we have at the moment is that it is too difficult to access out-of-hours care,” he said.
“People don’t feel confidence in the care they will get, if they speak to a GP, the GP probably won’t be able to see their medical notes and know about their background.”
Chris Hopson, chief executive of the Foundation Trust Network, said: “A&E services have been under huge pressure and although performance is now stabilising, there is a danger the system will fall over in six months time unless we plan effectively for next winter.”
He added that the current model of emergency care was unsustainable.
“NHS England has already done good work on developing a new model,” he said.
“We need Jeremy Hunt to commit to completing and then implementing the results of that work as quickly as possible, even though it’s likely to involve difficult decisions in the run-up to the General Election.
“These include relooking at the GP contract, reconfiguring some hospital A&E departments and investing more in community facilities.”
In a report drawn from research into 131 emergency departments across the UK, the CEM found attendance rates continued to rise in A&E departments in spite of efforts to reduce demand.
The report makes a series of recommendations for the government and health officials, including setting minimum consultant numbers and better methods to assess the quality of emergency departments.
The College also said that there should be a GP service within hospitals which could cater for as much as 30% of the current traffic which is presently seen in emergency departments.
Dr Taj Hassan, vice president of the college, said: “It is clear that working environments for them (consultants and middle grade doctors) at times are intolerable, associated with risk for them and their patients, and that action is required to stabilise our systems.
“The report has come at a timely juncture where our regulatory bodies and policy makers have also recognised this to be a crisis and suggested urgent action is merited.
“Our recommendations are based upon the need for close collaboration, system redesign, appropriate funding and sustainable working practices for care delivery and training.”
Groups representing GPs complained about the health secretary’s attack on out-of-hours coverage.
Royal College of General Practitioners chairwoman Dr Clare Gerada said she was “aghast at the constant denigration of my profession”.
She told BBC Radio 4’s World at One: “Isn’t it a shame that we are blaming a contract that is nearly 10 years old for a crisis that we are seeing today? Isn’t it a shame that we are blaming hard-working GPs who are doing their best for their patients one million times a day for something that is happening today in emergency departments?
“Isn’t it a shame that we focused only on hospitals? GPs have seen their workload double in the last five years.”
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