THE accident and emergency department at Hereford General Hospital has been under sustained pressure in recent months.

During August, in particular, it was often working to full capacity.

Jeremy Millar, chief executive of Hereford Hospitals Trust, said there was no single reason to account for the extra work but the number of accidents on county roads did play a significant part.

In a report to be considered at a trust board meeting this week, medical director Peter Harper referred to increasing admissions to the casualty department and to the medical unit. He said clinicians were concerned about the ability of the service to cope at times under this increased pressure which was often exacerbated by other hospitals in the vicinity closing their facilities.

He warned the trust might have to take the same action at times if the pressures became a threat to the safety of patients already admitted to hospital.

Mr Millar said it was not really a question of staff not being able to cope with the work but that at times facilities were stretched to the limit.

"You could get to a point when the department was absolutely full and you would have to consider asking ambulances to divert to other places,'' he said.

And the situation was arising were this could become more likely.