THE NHS in Wales must begin planning for the challenges of next winter now, if the problem of long waits in A&E is to be tackled, according to experts in emergency medicine.
Figures published earlier this week revealed that more than 4,000 patients in Wales waited longer than 12 hours to be dealt with in emergency units, almost 800 of whom had attended hospitals in Gwent.
The Royal College of Emergency Medicine (RCEM) in Wales is worried that a shortfall of beds and staff has contributed to another difficult winter for the health service.
And its vice president Dr Robin Roop, a consultant in emergency medicine, is urging health boards and policymakers to start preparing 2017/18 winter plans now.
“There is no doubt that emergency departments are struggling to keep up with demand this winter," he said.
“The worrying 12-hour data highlights that our emergency staff are finding it increasingly difficult to admit patients into hospital wards. This is in part due to a lack of available hospital beds and staff to keep up with the surges in patient numbers. 
“Our inability to admit patients into hospital inevitably leads to crowding in A&E units, longer waiting times, delayed discharges and a growing number of patients who are left waiting on a trolley in a corridor for a bed to become free.
"No patient should have to wait over 12 hours, especially in these crowded and stressful emergency environments. 
“The data also shows that 79 per cent of patients waited under four hours to be seen in January 2017. Although this is a very slight improvement when compared to the same month last year, we are still far below our target of 95 per cent."
In Gwent's acute emergency departments last month, a total of 797 patients waited more than 12 hours to be dealt with, the largest amount on record.
A comparison with previous January figures indicates a growing problem in this regard.
In January 2014, 122 patients waited longer than 12 hours in Gwent A&E units. This rose to 478 in January 2015, and 530 in January last year, before this year's record amount.
It is a trend mirrored across most of Wales, and a significant contributory factor this year was an extremely busy first 10 days in January, when emergency units struggled to deal with the numbers of patients attending.
At the Royal Gwent Hospital's A&E unit in January more than a third of patients (35.1 per cent) waited longer than the standard four hours to be dealt with.  
It was the same story last month for more than a third of patients who attended two other A&E units in Wales, at Morriston Hospital in Swansea, and at Ysbyty Glan Clwyd, at Bodelwyddan in north Wales.
Despite the difficulties, and despite being way off the 95 per cent target, there was a slight improvement in the amount of patients seen within four hours at A&E units in Wales in January - 74.1 per cent, compared to 73.8 per cent in the same month last year.
Dr Roop said that small improvement "demonstrates how hard working, tireless and dedicated our emergency care staff are, even when working under extreme pressures."
But he warned: “To adequately prepare for winter 2017-18, we believe that planning needs to start now.
"Only this way will we ensure that the four-hour data continues on its upward trend and guarantee that no one has to wait more than 12 hours.
"RCEM Wales will continue to engage with the (NHS Wales) unscheduled care board, the cabinet secretary for health, wellbeing and sport (Vaughan Gething) and other stakeholders, so that we can strive for greater improvement and ensure that patients receive the best possible care.”