HOSPITAL bosses have warned that "significant" pressures on emergency services are expected to continue throughout the winter.

A “sharp spike” in cases of flu has been identified as a major factor behind the high volume of people attending A&E in recent weeks.

There has also been a rise in demand from younger people who have not had an accident or an emergency visiting the department.

This comes after Royal Bolton Hospital triggered a "Black Alert" last week when just four beds were free for new patients at one point.

The incident, declared on Monday, December 9, came on the second of two consecutive days in which more than 400 people attended A&E.

Chief operating officer Andy Ennis told the NHS Foundation Trust board of directors how events unfolded.

He said: “On Sunday night, I was in contact with some of the managers. On Monday when I arrived it was clear that we needed to do something different as we were heading for another 400 day.

"On Monday, we discharged more patients than we admitted and on Tuesday we did the same. We can’t do it every day but we sat at the front door and reviewed patients coming in and looked at alternatives."

Mr Ennis thanked staff who got their "sleeves up" and smiled as the helped the hospital recover in what he described as a "true team effort".

But he told the board he expects January to be even more challenging than December.

He said: “The whole of Greater Manchester is under a similar situation so we are not alone but it means we aren't able to get support from Wigan and Salford.

“Hopefully with Boris’s money and extra staffing we won’t have to wait much longer but it hasn’t quite come in yet."

Speaking after the meeting, Mr Ennis told The Bolton News that cases of flu are "through the roof".

He advised those with symptoms of flu to visit their pharmacist first and encouraged everyone to get vaccinated with a flu jab.

Mr Ennis also revealed that the number of older people attending A&E has fallen but there has been a rise among 16 to 40-year-olds.