MORE than 1,500 patients waited over four hours in Gwent accident and emergency departments last month, with more than 220 forced to wait more than eight hours.

The busiest month in the area's A&E units since April last year saw 12,431 people come through the doors at the Royal Gwent and Nevill Hall Hospitals.

That was 3,000 up on July and August. Such was the demand that while the 10,900 patients dealt with inside four hours was more than the total seen in all but three months over the last year, the percentage - 87.8 per cent - was the lowest in Gwent for years and the lowest among Wales' seven acute hospital trusts.

A&E departments are struggling to cope with rising demand, but reasons for the increases, or for such fluctuations month-on-month are not fully understood.

The Assembly wants at least 95 per cent of A&E patients dealt with inside four hours, known as the transit time. Only once in recent years, last March, was that figure achieved in Gwent. No-one should wait more than eight hours.

No-one from Gwent Healthcare Trust was available to comment on the September figures. But trust bosses warned last spring that improved performance was unsustainable in the long term without more resources and improvements to the Royal Gwent's department.

A&E at Nevill Hall in Abergavenny, currently undergoing an £800,000 expansion, regularly meets the 95 per cent target, but the Royal Gwent has ongoing difficulties.

The department suffers from poor layout and has not had enough senior medical cover. Though three A&E consultants have recently been appointed, difficulties remain in recruiting doctors.

There is ongoing tension between the need to treat emergencies and dealing with minor cases, with staff often called from dealing with the latter when a run of serious cases comes in. There is concern too, that too many people attend A&E unnecessarily.

Despite being Wales' busiest NHS trust in terms of patients coming through A&E, Gwent has consistently outperformed its neighbour Cardiff and Vale, against the four-hour transit time target.

But in September, while still short of the 95 per cent target, A&E departments in Cardiff and Vale hospitals dealt with a higher percentage of A&E patients inside four hours than Gwent, for the first time in years.

Accident and emergency units in Gwent Month People attending Dealt with inside four hours Outside four hours Outside eight hours July 9,692 8,849 (91.3%) 843 97 August 9,366 8,626 (92.1%) 740 75 September 12,431 10,914 (87.8%) 1,517 224