GWENT hospitals have for the first time met the target for dealing with 95 per cent of patients attending A&E inside four hours.

Much improved performance in A&E at the Royal Gwent during March, allied to another strong showing at Nevill Hall in Abergavenny, meant an overall 96.2 per cent of the 11,632 patients who attended these two departments last month were dealt with inside the Assembly-set target time.

But Gwent Healthcare Trust believes investment, allied to closer working with ambulance and out-of-hours GP services, are vital if the improvements are to be sustained.

Gwent Healthcare Trust's two major A&E departments deal with more patients - almost 58,000 last year, or more than 1,000 a week - than their counterparts in any other single NHS trust in Wales. A&E at the Royal Gwent is Wales' busiest.

Three years ago, barely eight-in-10 patients were being dealt with inside four hours. Significant investment, not least in separating major and minor A&E cases at the Royal Gwent, have helped improve performance, along with more staff and new roles for staff.

"The implementation of a 'see and treat' structure for minor injuries, led by nurse practitioners, has been very successful," said a trust spokesman, who added that weekly monitoring and closer links with ambulance crews, have also helped in speedier assessment.

"Investment in the A&E department at Nevill Hall Hospital is drawn up (a £700,000 scheme) and is being planned for the Royal Gwent Hospital.

"Both will improve the environment and the speed in which patients are seen and treated.

"Staff have played a crucial role, but accident and emergency demands are virtually impossible to foresee. There will always be times when acute pressures cause delays, however hard everyone works to avoid them."

Ninety-three per cent of 500 nurses questioned for a Royal College of Nursing survey felt unduly pressured to deliver the four-hour target.