A&E numbers and admissions at Hereford County Hospital showed signs of easing off over the weekend, but the hospital will stay at “critical incident” status for the time being.

Over Saturday-Sunday 222 patients attended A&E – 112 on the Saturday and 110 on the Sunday.

Sixty-two patients were admitted on Saturday, 33 from A&E, and 38 on Sunday, 26 from A&E.

Wye Valley NHS Trust is still urging patients to consider alternatives to A&E with the hospital staying at critical incident status called a week ago.

Subsequent days saw the hospital under unprecedented pressure over patient numbers.

 An A&E designed to handle no more than 125 patients a day was regularly recording in excess over 150 patients a day over Christmas-New Year.

With bed availability at a maximum of 220, a single day last week saw 57 emergency admissions all described as “extremely sick” and in need of urgent care.

At one point, the pressure was so acute that the hospital had nearly 50 patients in A&E, five waiting on trolleys to be seen, a full Clinical Assessment Unit, a full discharge area, and a single resuscitation bay free.

Many routine operations have had to be cancelled with knock on effects to the trust’s tightened finances.

Trust chief executive Richard Beeken told the Hereford Times that he was ready to call a critical incident at Christmas but preferred to wait until partner agencies had the staff in place to help.

Critical incident status means the trust can redeploy staff and cancel operations to prioritise urgent care and treatment.

Figures show that over the last three months of 2014, 85 per cent of people attending A&E were seen within four hours against the national target of  95 per cent.

During the Christmas and New Year period, this figure fell to 74 per cent due to the increase in patients.

Senior medical staff at the hospital – put into special measures in October – have pressed for “critical incident”  status to continue to clear the backlog of patients, admissions and operations.

On Monday last week, when the critical incident call was made, 135 patients attended A&E and 57 emergency admissions accepted.

By then, demand levels described as “unceasing and unprecedented” had taken the hospital to a “level 4” alert – the point at which demand exceeds capacity by 30 to 40 per cent.

Daily attendances at A&E topped 164 over Christmas- New Year.

The trust has the power to declare an internal incident if it feels pressures in A&E present a serious threat to the disruption of its services.

Critical incident status means:

-  Staff leave and training leave cancelled with support brought in from the trust’s staff bank, agencies, and volunteers for extra shifts.

- The cancellation of routine outpatients appointments to release consultants to urgent care.

- Elective surgery areas adapted for A&E assessment.

- A control room maintained as a situation management centre.

- Assistance sought from the Clinical Commissioning Group and Herefordshire Council from extra GPs to the faster confirmation of care packages allowing patients to be discharged.

Extra ambulance space has also been found with turnaround a major issue as emergency vehicles wait with patients while blue light calls come in.

At one point last  Tuesday afternoon, seven ambulances - almost the entire fleet available to the county at the time - were waiting outside A&E to admit patients.

As yet, West Midlands Ambulance Service has not been asked to divert incoming patients away from Hereford A&E.