WAITS of more than 12 hours for patients in accident and emergency departments in Wales rose again during October, with the figure for Gwent topping 300 for the first time in 18 months.

The last two months have seen the highest number of waits of over 12 hours since April 2013, but the October figure of 348 will be concerning for Aneurin Bevan University Health Board bosses, given that it was 65 higher than for September, when there were 855 fewer attendances.

The Royal Gwent Hospital’s A&E unit accounted for 271 of October’s waits, which was the third highest figure from any of the individual hospital A&E units in Wales behind Ysbyty Glan Clwyd (399) in north Wales, and Morriston (295) in Swansea.

Increases in what are known as ‘major’ cases coming into A&E, are a big issue, not only in Gwent but across Wales.

But an illustration of the challenge is that 44 per cent of patients arriving at A&E at the Royal Gwent and Nevill Hall Hospitals are now classed as major cases. That is 3.5 per cent up on October last year, and 16.5 per cent up on October 2011.

Major cases are more pressing and often more complex, requiring the input of more staff.

The increase in major cases reflects changing demographics, with an increasing older population. Older people who come into A&E tend to present with more than one health problem, and dealing with the immediate issue also involves taking into account the effect on an existing underlying condition.

Arrivals in A&E by ambulance have risen by more than a third to around 38,000 in 12 years. More than half of these ambulance arrivals, and up to 58 per cent in October, do not result in an admission, calling into question whether an ambulance was needed in the first place.

Despite the increase in waits longer than 12 hours in October, Aneurin Bevan University Health Board dealt with the biggest proportion of A&E cases inside the standard four hours of Wales’ six health board areas with such units.