Heart of England NHS Trust reported its worst A&E performance in more than TWO YEARS last month - with nearly a quarter of patients waiting more than four hours.

Just over three quarters or 76.3% of people waited less than four hours from arrival to admission, discharge or transfer in the trust’s A&Es in December, the worst performance in the local area, and the trust’s worst performance since the performance measure began to be recorded monthly in June 2015.

The Trust runs Birmingham's Heartlands Hospital, Good Hope Hospital in Sutton Coldfield and Solihull Hospital.

Performance in December was down from 77.1% waiting less than four hours in December 2016.

Ambulances outside Heartlands Hospital A and E department.

Other trusts in the local area recording their worst A&E performance in December were Sandwell and West Birmingham, 78.6%, down from 84.2% in December 2016, and the Dudley Group, 78.9%, down from 87.7%.

Conversely, A&E performance at University Hospitals Birmingham has been improving since a low of 73.2% in December 2016, with 89.8% of patients waiting less than four hours in December 2017.

Across England, A&Es reported their worst A&E performance on record in December, as 85.1% of patients waited less than four hours from arrival to admission, discharge or transfer, the worst monthly performance since records began in August 2010.

Heartlands Hospital, in Bordesley Green.

The number of people waiting more than four hours topped 300,000 for the first time as well, the equivalent of one in seven people attending A&E. This was an increase of 11.9% compared to 268,818 in December 2016.

Good Hope hospital, in Sutton Coldfield

Performance compared to 88.9% waiting less than four hours in November, and 86.2% in December 2016, with the 95% target missed for the 29th month in a row, according to the figures released this morning by NHS England.

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Nearly 500 people waited more than 12 hours from decision to admit to admission, so called trolley waits. However the number, 497, was down from the 553 waits of this length in 2016.

The Royal College of Surgeons said it was "disappointing" that just 77.3% of patients at major A&E departments were treated within four hours, worse than in December 2016 when 79.3% of patients were seen.

A spokesman added: "It further demonstrates why it has been necessary to cancel patients' non-urgent procedures until the end of January.

"Despite the best efforts and dedication of NHS staff to treat patients quickly, waiting times for non-urgent care have also deteriorated again in the past year."

The figures show that bed occupancy levels have gone back up to 95%, but, more positively, delayed transfers of care - when a patient is ready to leave a hospital - were lower than at the same point in any of the past four years.

Dr Nick Scriven, president of the Society for Acute Medicine, said: "These figures support the messages we have been getting from our members about conditions across the NHS and the struggle they are facing to provide safe and compassionate care in exceedingly difficult conditions."

Health Secretary Jeremy Hunt

But he said the figures released by NHS England "pre-date the influenza spread and escalation in England and, combined with the additional numbers of people in corridors on trolleys or as extra capacity, do not tell the extent of this crisis".

He agreed with Chris Hopson, chief executive of NHS Providers - the trade body which represents NHS services - who described the NHS as being at a "watershed moment".

Mr Hopson said investment on a long-term basis - and help with the immediate financial impact of "exceptional winter pressures" - was needed to address the "fragility of the wider NHS".

In a letter to Health and Social Care Secretary Jeremy Hunt, he said: "Despite planning for winter more thoroughly and extensively than before, it hasn't been sufficient. Rising numbers of flu cases and more respiratory illness have placed intolerable pressures on staff.

"The NHS is no longer able to deliver the constitutional standards to which it is committed. We need to be realistic about what we can provide on the funding available.

"If we continue to run the NHS at close to 100% capacity, day in, day out, permanently in the red zone, it's not surprising that the service can't cope when we get a high, but entirely predictable, spike in demand."