Long waits at hospitals in Wales has led patients walking out without being seen.
854 patients left the emergency department of Wrexham Maelor Hospital without being seen in July.
There was also a slight deterioration in Glan Clwyd Hospital but a slight improvement in Ysbyty Gwynedd.
In a report at this week’s meeting of the Betsi Cadwaladr University Health Board, head of operations Morag Olsen says the majority of those who left without being triaged did so within 30 minutes of arrival.
In July, 77% of patients were seen within four hours, a slight drop from the June figure, though there was an improvement in Wrexham.
In the same month 1,095 patients waited more than 12 hours, 112 more than in June, with Ysbyty Gwynedd showing the best figures.
The report says that attention is being focussed on the time it takes to see patients and the risks of harm to patients who are delayed for long periods in emergency departments is being reiterated to staff.
There are over 200 vacancies for registered nurses across the region with recruitment overseas gaining in popularity.