WAITS of more than four hours in Newport's Royal Gwent Hospital's accident and emergency department should be limited to one in every 20 patients by early autumn.

That is the aim of a plan from Gwent health bosses to reduce such waits at the area's busiest hospital in line with Assembly-set targets.

Ninety-five per cent of patients attending A&E departments in Wales should be dealt with within four hours, a period known as the transit time.

This target is comfortably met at Caerphilly District Miners Hospital and almost met at Nevill Hall Hospital in Abergavenny, but the Royal Gwent is nowhere near achieving it. Fewer than three-quarters of its A&E patients (72.4 per cent) were dealt with inside four hours in the year to March 31.

Gwent Healthcare Trust has teamed up with Local Health Boards, ambulance services and the Assembly to draw up and agree a plan to improve the situation.

More than £700,000 has been awarded by the Assembly for a revamp of the A&E department, but problems with slow transit times are not solely down to A&E.

Other changes to systems to try to keep patients out of A&E at the Royal Gwent are being explored, some of them radical. Into the latter category falls a proposal relating to the ambulance service. Currently, all 999 calls through the service must go to A&E, but pilot schemes are being considered which might see paramedics using different methods, such as using minor injuries units where appropriate, as an alternative.

Ward problems at the Royal Gwent which lead to beds not being available quickly enough or at times of greatest demand will also have to be addressed.

Extra porters and domestic staff are among the proposals. Prompt discharge of patients fit to go home is also a key area for improvement.

While delayed discharges have been decreasing in Gwent, hospital bosses want to cut the average length of stay for patients with chronic disease, by strengthening packages of care available outside hospital.

It is hoped that 90 per cent of Royal Gwent A&E patients will be dealt with within four hours by the summer, increasing to 95 per cent by the end of September.