THE Royal Gwent Hospital's A&E department endured its busiest ever January last month, as the number of patients attending topped 7,000.

Demand was such that the actual figure - 7,057 - was 7.2 per cent, or 474 patients, higher than that for the same month last year.

And it contributed to the busiest ever January in Wales for hospitals' emergency departments.

Once again, A&E departments have struggled to deal with the demand. A little more than one third of patients who attended at the Royal Gwent last month waited more than four hours to be dealt with.

Some 66.2 per cent were dealt with within that time, but this was the third lowest rate of Wales' 13 A&E units.

The unit at Nevill Hall Hospital in Abergavenny dealt with 78.2 per cent of its 3,582 January patients within four hours, the fifth highest rate in Wales.

Attendances have risen considerably during the past 10 winters, with the Royal Gwent A&E unit dealing with 27 per cent more patients last month than in January 2010.

While the number of patients classed as 'minors' - deemed less serious - has levelled off generally in recent years, there has also been a noticeable increase in 'majors', more serious cases, more often than not elderly and presenting with a number of other health issues that can make treatment of the problem for which they have come to hospital more complex and requiring the input of more staff over more time.

Aneurin Bevan University Health Board's interim director of operations Claire Birchall last month told board members that January had been "tough", with the local and national picture "very challenging", and the official figures and performance rates bear that out.

For health boards across Wales, achieving the target of a minimum 95 per cent of A&E patients being dealt with inside four hours remains a very distant dream.

Two, albeit small, chinks of light however: The 66.2 per cent of A&E patients dealt with inside four hours at the Royal Gwent in January was actually an improvement, though slight, on the previous two January results; and the number of A&E patients at the Royal Gwent and Nevill Hall combined, who waited more than 12 hours in January was 685, down from 725 in January 2018, and 795 in January 2017, though it must be stressed that the Wales-wide target is for zero 12-hour waits.

Health minister Vaughan Gething said an increase in numbers of seriously ill patients attending, with “big spikes in cases of flu and gastroenteritis" contributed to pressure.

Despite the lower general level of flu this year, he added that there have been "more flu cases confirmed in hospitals so far this winter than the same time last year."

“It is testament to our hard-working NHS staff that despite this pressure the number of patients seen and treated within the four-hour target was the highest for January since 2014."

Welsh Conservatives however, pointed out that there was a reduction of over-70s attending A&E in January compared to December 2018.

The party's shadow health minister Angela Burns said "this depressing circle of underperformance and mismanagement has become the new normal".

"It is true that an ageing population and Welsh Government failure to fill staff shortages are having a huge negative impact on the ability of NHS Wales’ A&E departments to meet demand," she said.

“But these are not blips or inconveniences. They are the reality in which healthcare must be provided in Wales. One cannot stop demographics of patients, but a change of management at the top is possible through a change of government."