WHILE two patients died at Worcester's crisis-hit emergency department more than 100 others waited over 12 hours on trolleys.

The harrowing scale of the winter crisis at Worcestershire Royal Hospital was laid bare at a meeting as one NHS boss described the situation as heart-breaking.

Waits on trolleys at Worcester have already been branded 'unacceptably long' by Health Secretary Jeremy Hunt who has concerns about a spike in respiratory infections and flu as more cold weather arrives this weekend.

He said: "The most recent statistics show that nearly three quarters of trolley waits occurred in just two trusts. In Worcestershire, in particular, there have been a number of unacceptably long trolley waits, and the media have reported two deaths of patients in A&E.”

In total 109 emergency patients waited on trolleys for more than 12 hours at Worcester and Redditch between December 20 last year and January 4 this year.

Three patients died at Worcester between Saturday, December 31 and Tuesday, January 3, one hanged on a ward and two dying on trolleys. One of the two trolley patients died from a cardiac arrest after waiting 35 hours and the other died following an aneurysm.

The huge challenge facing Worcestershire Acute Hospitals NHS Trust, which remains in special measures, was revealed at a board meeting at the Alexandra Hospital in Redditch on Wednesday.

It was a chance for the trust's leaders to answer questions from the public, including Peter Pinfield, chairman of Worcestershire Healthwatch, and Graham Vickery of the health overview and scrutiny committee.

Trust chairman Caragh Merrick, said reports that the patients had died in an A&E corridor were not correct. The Worcester News has been told by the trust that the patients died on trolleys in cubicles in Worcester's A&E.

Ms Merrick, who said she could not be other than impressed by the efforts of staff, said of the pressures: "It breaks my heart to see it. We have to do all we can to make sure this doesn't happen again."

Investigations into the deaths are ongoing. Jan Stevens, the trust's interim chief nursing officer, said she had received the initial case review about the deaths.

The terms of reference for the investigation and the person set to conduct it are scheduled to be agreed on Thursday with feedback provided to the board in due course.

A serious incident should be officially closed within 60 working days she said.

The trust leaders say it is not possible to ascertain at this stage whether or not the deaths were linked to winter pressures on A&E.

Mrs Merrick said: "We meet at a time when the trust is particularly challenged. A lot of the care issues we have are not what we would aspire to. First and foremost, the priority of this board is patient safety.

"What we can say definitely is that none of these deaths occurred on a corridor."

Gareth Robinson, interim chief operating officer, said there had been significant pressure in the system, stressing that it was both a national and regional issue.

He also said part of the problem was the lack of capacity in Worcester which was effecting the patient flow through the emergency department.

Much of the pressure has come from patients being taken to hospital by ambulance with a 15 per cent increase over Christmas and New Year compared to the same week last year.

The pressures have become so great that all elective (non-emergency) operations and procedures were suspended on Christmas Eve.

Elected work was set to resume on January 16 but hospital bosses say it may be more likely to happen at the end of this month as pressure on the system remains high.

During this period some elective work related to cancer and 'life and limb' related surgery continued unaffected.

The trust has yet to release data on how many operations have been cancelled.

A short-term response to the crisis will be to open between 12 and 14 beds on Avon 5 at Aconbury at Worcestershire Royal, something they are looking to do as soon as possible.

Before Christmas NHS bosses were also able to open 12 extra beds at the Alexandra Hospital in Redditch which they are looking to keep as a permanent arrangement.

The trust has applied for £29 million from the Government which would make use of the Aconbury building at Worcester, allowing the trust to potentially open 81 beds.

John Burbeck, the trust's vice-chairman, praised staff as 'quite superb' and said the situation was not fair on patients or staff, arguing that problems needed to be addressed by the whole health economy and the community, not just the acute trust.

Worcester has been at capacity and on eight occasions ambulances have had to be diverted from Worcester to Redditch during the Christmas and New Year period.

In total at least 95 per cent of patients are supposed to be seen, treated, then admitted or discharged in under four hours and it is understood this has slumped to around 75 per cent during the crisis.