MORE than 10,000 patients spent over 12 hours in major Welsh A&Es in October, as doctors warn system is “in a spiral” and Pembrokeshire families feel the impact

WALES has recorded its worst October on record for A&E waits, with new figures showing 10,493 people waited more than 12 hours in major emergency departments before being admitted, discharged or transferred.

The Royal College of Emergency Medicine (RCEM) described the latest StatsWales data as “dismaying” and said the figures show politicians are still not listening to “alarm bells ringing from every ED in the country”.

For patients in Pembrokeshire, the numbers sit against a backdrop of continuing pressure at Withybush Hospital and across Hywel Dda University Health Board, which remains under enhanced Welsh Government “targeted intervention” and level-4 escalation for urgent and emergency care – one step below special measures.

Worst October on record

StatsWales’ October 2025 data for major Welsh emergency departments show:

• 10,493 patients waited 12 hours or more – roughly one in seven people attending a major ED.
• Around one in four (24.8%) waited at least 8 hours.
• Only 53.9% were admitted, discharged or transferred within four hours – far short of the 95% target.
• 1,493 bed days were lost because medically fit patients could not be discharged, only a small improvement on last year.

RCEM Wales vice-president Dr Rob Perry said another worst-ever month heading into winter was “dismaying” and warned that thousands of patients were left on trolleys or chairs “for hours on end in conditions we know put them at risk of further harm”.

He said emergency staff were “working themselves to the bone” to keep people safe, but minor improvements since September were just “a drop in the ocean” compared to what is needed to escape the “spiral” of crowding and delay.

Hywel Dda still under targeted intervention

Hywel Dda University Health Board – which runs Withybush, Glangwili, Prince Philip and Bronglais hospitals – is one of several Welsh boards in escalation for urgent and emergency care performance. It is currently at level 4 for finance, strategy and planning, urgent and emergency care outcomes, and a number of “fragile” services.

Board papers going to Hywel Dda’s November 2025 meeting show:

• Twelve-hour A&E waits across the health board in October stood at 8.5% of attendances – slightly better than the board’s own plan trajectory of 9.2%, but still above the 7% level required for de-escalation.
• Ambulance handovers taking more than an hour fell to 528 in October, better than the internal plan (803) and below the external de-escalation threshold (680) – but discharge delays remain “materially above trajectory”, continuing to block beds and choke the system.

The board’s Annual Plan for 2025-26 commits to reducing long waits and ambulance delays as part of a wider push to “shift left” – moving more care into community and primary-care settings and away from full-blown hospital admission wherever safe.

In its escalation documents with Welsh Government, Hywel Dda has also been told to improve how it directs people to the right service, with a specific requirement to “ensure that patients are clear where they can and should access support, signposting away from emergency services.”

Pembrokeshire families already seeing the impact

The latest national A&E figures land in the same week that a Pembrokeshire inquest again highlighted the human cost of delays and mis-triaged emergency calls.

As The Herald reported, Pembrokeshire coroner Mark Layton has now heard final evidence in the death of 40-year-old Llanteg mother-of-two, Charlotte Burston, who fell ill with chest pain on Christmas Day 2023. Her teenage daughter called 999 twice but was told an ambulance could take more than an hour; a relative set off to drive her towards Withybush instead.

Charlotte suffered a heart attack at Robeston Wathen and later died at Morriston Hospital on New Year’s Eve. The inquest heard that an Advanced Paramedic Practitioner based in Haverfordwest, around half an hour away, was on duty and clinically appropriate for the symptoms, but was not dispatched.

Mr Layton was told that Charlotte “may have survived” if the Welsh Ambulance Service had allocated the correct clinical resource.

For families in Pembrokeshire, that finding, alongside Wales-wide A&E data showing record 12-hour waits, will fuel ongoing questions about whether Hywel Dda and national leaders are moving fast enough to fix the front door of the NHS before this winter bites.

What patients are being told to do instead of A&E

Part of Hywel Dda’s escalation action plan is about changing how people access help in the first place, and making clearer when A&E is – and isn’t – the right option.

Current advice from the health board and local partners in Pembrokeshire is:

• For life-threatening emergencies – such as loss of consciousness, suspected stroke, severe breathing difficulties, chest pain that could be a heart attack, severe bleeding, or serious injuries and fractures – dial 999 or go to the Emergency Department at Withybush General Hospital.
• For urgent problems that cannot wait for a routine GP appointment but are not 999 emergencies, residents are told to phone NHS 111 Wales. This includes Hywel Dda’s GP out-of-hours service and, via option 2, a 24/7 mental-health line staffed by specialist professionals.
• For minor injuries – such as sprains, cuts, minor burns, simple fractures and some minor illnesses – patients can use nurse-led Minor Injury Units. In Pembrokeshire that includes services linked to Withybush and Tenby, usually open 8am to 8pm, with minor-injury care overnight provided through the main Emergency Department at Withybush.
• For routine issues like repeat prescriptions, ongoing illnesses or contraception, people are expected to see their GP or practice nurse.
• For self-care and common conditions like coughs, colds and sore throats, pharmacies and community support are promoted as the first port of call.

Pembrokeshire County Council echoes the “choose well” message, warning that using A&E for non-emergencies can delay treatment for those in genuine life-threatening situations and leave other patients waiting longer on trolleys and in corridors.

Winter fears

RCEM Wales has welcomed recent Welsh Government funding for social care but says it will take “sustained support” to fix hospital flow and delayed discharges – the back-door pressures that sit behind front-door A&E queues.

Dr Perry said emergency medicine staff would “step up” again this winter, but warned that without stronger action on bed capacity, social care and realistic targets, the system will keep relying on extraordinary efforts from exhausted staff – and patients will continue to bear the risk.

For Pembrokeshire, where families like Charlotte Burston’s are still living with the consequences of delayed emergency care, today’s record October figures will only intensify scrutiny of Hywel Dda’s performance – and whether its plans to reduce 12-hour waits at Withybush and other sites are being delivered fast enough.