THE A&E department at Royal Bolton Hospital is under “significant pressure” as the demands of winter set in earlier than usual.

Almost one in three patients attending A&E are waiting more than four hours to be seen.

More than 400 people visited the emergency department every day for three consecutive days last week.

Bolton NHS Foundation Trust chief operating officer Andy Ennis said that “400 plus days” typically occur once a year but this month alone there have been four.

He said: “We have been under significant pressure. In September, we had an improving position, bucking the trend nationally, and locally in Greater Manchester until the month of October. Winter has kicked in with a vengeance. The numbers coming through are significant.”

This comes after October was reported as the busiest month ever at Bolton’s A&E department with only 70 per cent of patients treated within the four-hour target.

Public sector trade union UNISON has said that services are now at “breaking point”.

Mr Ennis said that the figures for November have improved slightly but services are still under “significant pressure”.

He also told the board of director’s that an extra 26 beds have opened in a hospital ward this month, with a further 12 expected to open within community facilities across the borough.

Dr Wirin Bhatiani, chair of Bolton’s clinical commissioning group, urged people to ring their GP practices so they can be directed to the appropriate place.

He said: “In Bolton we have a very strong partnership to help deliver the best health and care possible. All parts of the system are working together whilst under significant pressure, and winter has not fully hit us yet.

"Our GP practices along with the hospital are experiencing increased demand, and our A&E department has seen many more people compared to this time last year.

“I would urge people to use the GP appointments that are available at evenings and weekends, in one of three hub sites across communities. This would help our town to manage the increasing demand – speak to your GP practice to find out more.”