Hospital bosses have issued a warning after seeing the busiest day in their history on Monday.
246 patients attended A&E on February 22, which they described as part of an “ongoing tend”.
The department first opened in 1964, and was designed to treat up to 180 patients per day.
Dr Stuart Lloyd, chief of emergency medicine, at the Trust, said: “While we struggle, and cope, with this increase in patient numbers we are mindful that this rise will continue.
“Our paramount issue for A&E is patient safety while caring and treating very sick people – and this is being hampered by the facility in size and shape.
“The current team of dedicated doctors and nurses are conscious that patients often remain in the waiting area as all our cubicles are full.
“It is time that both the hospital and commissioners look at the long term implications of the unit remaining in its current form. Bedford hospital patients are becoming older and sicker and need a local A&E that is modern, accessible, clean, technologically advanced and of a size able to support the large numbers that will continue to arrive for care.”
Dr Lloyd has 12 years’ experience of emergency medicine, and added that he was frustrated when his team could not assess and treat patients in a timely safe manner because of the demands of the department.
Hospital chief executive Stephen Conroy said: “The trust will always consider the medical advice of our consultants and, while ensuring public funds are spent appropriately, we will be developing a feasibility study to ensure our A&E is fit to treat and care for our Bedford patients now and for the next 20 years.”