Emergency services are preparing for a weekend that could be as busy as New Year's Eve when pubs reopen in most of England on Saturday.

Police federation leaders warned that the public will be "out in droves" on July 4, with one fearing a return to Accident and Emergency departments resembling "a circus full of drunken clowns" at weekends.

Metropolitan Police Commissioner Dame Cressida Dick said her force has been planning for July 4 "for some time" and that the public will see "a lot" of officers on London streets.

She told the BBC Radio 4 Today programme: "There will be a lot more ready should people be out of order, should people get violent. But I'm not predicting that at this stage."

Hospitals have also been told to make preparations for a surge of patients in A&E ahead of the mass reopenings.

In an email from NHS England officials to hospital trusts seen by the Health Service Journal (HSJ), managers were told to "ensure that your demand/activity planning reflects a busy weekend, with peaks in activity into the evenings similar to that of New Year's Eve".

Managers were also told to reflect the likely surge in their staffing as well as reducing bed occupancy ahead of the weekend in case of a rise in admitted patients.

The email was sent by regional NHS England chiefs in at least two of the seven regions, the HSJ said.

Tim Clarke from the Metropolitan Police Federation, that represents officers up to the rank of chief inspector, said he feared this weekend "could be anything but a 'Super Saturday' for police officers".

He said: "This could have been mitigated by waiting until Monday to further relax the Government guidelines to us all - but as always, policing and police officers will do the best we can in the challenging circumstances."

Brian Booth, chairman of West Yorkshire Police Federation, warned that alcohol fuels crime and puts more strain on the emergency services.

He said: "Police officers are right to have concerns about this weekend and Government restrictions being lifted based on our experience of people's behaviour changing when alcohol is involved.

"We have more violence, street disorder, sexual assaults, missing people and injured people who may need medical assistance. All of these impose significant strain on policing and our colleagues in the NHS.

"Having seen the effect of fast food drive-thru outlets in West Yorkshire opening, and some of the public behaviour which followed, my concerns are heightened purely due to alcohol and the issues this brings.

"Prior to the Covid-19 outbreak, local A&Es on Friday and Saturday nights were at times akin to a circus full of drunken clowns. We do not need this once again.

"It is known that alcohol lowers inhibitions and I truly hope the vast majority of public maintain their common sense, remembering we are still living under the cloud of Covid."

Dr Ian Higginson, vice president of the Royal College of Emergency Medicine, said increased demand on emergency departments this weekend is "somewhat difficult for us to think about" for already-stretched staff.

He told the PA news agency: "Staff aren't particularly looking forward to a weekend where numbers could potentially increase and that increase could be in relation to alcohol.

"I would urge the public to think about hospitals and think about emergency departments in that way and to continue to look after the NHS and their staff and to be considerate in the way they behave to try and not end up in our departments."