WALES' accident and emergency departments experienced their busiest ever January collectively last month.
Attendances by patients aged 85 and over - the second highest on record, for any month - and the worst flu season in several years, combined with the usual winter demands to crank up the pressure on staff.
In all, 64,230 patients attended major A&E units in Wales in January, 1,226 - or almost two per cent - more than during January 2017.
In Gwent, the year-on-year increase was steeper, the units at the Royal Gwent and Nevill Hall Hospitals accounting for a little above a third of that Wales-wide increase.
Last month, 10,145 patients attended these two units. This amounted to 411 more patients than during the previous January, a rise of 4.2 per cent.
Across Wales, 78 per cent of patients who attended A&E were dealt with inside four hours, though this figure also includes those who were seen at other emergency departments and minor injuries units. The figure for January 2017 was 79 per cent.
Nevill Hall's A&E unit dealt with 79.3 per cent of its patients in under four hours last month, the third highest performance of Wales' 13 major units. This was down on the 83 per cent for January 2017.
Performance at the Royal Gwent unit was 65.3 per cent last month, the third lowest in Wales, but this was marginally better than for the less busy January 2017 (64.9 per cent).
There were 725 patients who endured waits of more than 12 hours in Gwent's A&E units last month, a reduction of 70 on the previous January that was due entirely to a decrease at Nevill Hall.
The Welsh Ambulance Services NHS Trust recorded its second highest month of activity on record in January, but managed to maintain its record of meeting the national target for responding to the most serious 'red' calls.
Overall in Gwent, the ambulance service dealt with 7,879 calls last month, six per cent up on January 2017. Within that total were 425 'red' calls requiring an on-scene response - up by almost a quarter (23.5 per cent) year-on-year.
Of these 'red' calls, 71.1 per cent received an on-scene response inside eight minutes. The target is a minimum 65 per cent.
An indication of the pressures that hospitals and their staff found - and continue to find- themselves under is the amount of delayed transfers of care (DToCs), patients still occupying a hospital bed despite being fit for discharge.
There were 109 DToCs in Gwent hospitals according to the January audit. This was the second highest January figure in the last 10 years. The highest was 113 in 2016, but in January last year there were 61.
NHS Wales chief executive Dr Andrew Goodall praised staff in the NHS and social care sectors for continuing to deliver emergency and planned care with "compassion and professionalism".
"I would like to thank them for their exceptional commitment and hard work during this extremely challenging period," he said.
"Despite record levels of demand on service, our staff have provided a resilient and professional response to support patients this winter.”