It's not long past 11am and 72 patients and 21 ambulances have alreadydescended on the Royal Gwent hospital in Newport. Staff say it isextremely busy, but it can be even busier.

When I arrive with my camera operator, there are five ambulancesoutside. If the symptoms of a busy hospital had colours, they would begreen and yellow.

Patients waiting outside means no space inside.

Walking through the front door I am met with a hum of activity. Staffcalmly, but quickly, usher patients through double doors into the mainarea of the emergency department - they could give swans a run fortheir money.

Natalie Skyrme is a senior nurse on the department.

"A lot of these patients have been here over 12 hours. They're waiting for beds. The nursing staff are working to try and give them the care that they need", she told me.

Senior nurse Natalie said staff work around the clock to give patients the care they need

The aim here, is flow.

Improve patient flow through a hospital and the system runs smoothly and waiting times are shorter.

The Royal Gwent saw more than 7,000 patients attend its emergency departments in January

It is a simple theory, but one that's proving challenging not justhere, but across Wales.


More than 7,000 patients arrived at Gwent A&E in January

Last month, just over 7,000 patients arrived at the Royal Gwent's A&Edepartment alone.

It was its busiest January ever. 95% of patients should spend four hours or less here. In December 2018 only 63% did.

The whiteboard in the main A&E area is full - doctors and nursescontinually update the status of patients.

Old technology still has a place here. If there are beds available, then staff look to move patients through the department and into wards - or better still, home.

Further into the department is the medical assessment unit (MAU).We are guided by Natalie, the senior nurse in charge. On our wayshe says it is extremely busy in the unit - the people lining thecorridors are testament to that.

The first thing that hits you in the MAU is the noise.

Every bed, flanked by curtains - is full.

There is sometimes little privacy in a place like this. Medical staffoften prefer to keep curtains open to ensure they can observepatients' conditions.

Danny was one of the patients being cared for in the emergency department during filming

In one of the bays, watching the hive of activity around the nursesstation is Danny. "The place isn't big enough" he told me. "We needmore money. More money."

At 82 years old, Kathleen was among the youngest in a group of five being treated in hospital

Just yards away, in a chair with her bags packed for home, isKathleen. At 82, she muses how she can be among the youngest in a groupof five in hospital. The elderly make up a large proportion ofadmissions to A&E - particularly in winter when falls become moreprevalent.

Also ready to go home is Norma. She has spent three days in MAU - therehasn't been space on a ward. Admitted after a fit, she bemoans whatshe sees as an abuse of the service, "some are here with finger ache,"she told me.

It has just gone midday. We have been filming an hour and seen dedicatedstaff working to deliver high quality care faced with huge demand.

Every patient is full of praise and gratitude - but you are leftwondering how long hospitals can function in this way and whethergrand plans of government will be able to deliver a sustainablesolution.

When we leave, there are seven ambulances outside.

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