Emergency departments in Wales faced their busiest October on record last month, official figures show.
Nearly 91,000 people went to major A&E departments during that month.
75.3% of patients spent four hours or less in emergency departments. The target is 95%.
The ambulance service also saw its busiest month ever for the most serious calls, which have increased by 35% in the last four years.
Less than 55% of patients at Wrexham Maelor Hospital were seen within the four-hour target.
The number of patients waiting 12 hours or more in an emergency carefacility in Wales was 5,547 - an increase of 1594 patients compared to October 2018.
The Welsh Government said it has provided £30m to help ease pressures, and made it available earlier so that local authorities and health boards can better use it.
Despite this, the average waiting times in emergency departments have remained steady and the ambulance service exceeded its target for the 49th consecutive month. The number of delayed transfers of care also decreased in October.
The Royal College of Emergency Medicine in Wales said that in major departments only 69.7% of patients were seen within the four-hour target.
It says that's a decrease of 5.7 percentage points when compared to October 2018 and is stressing the "urgent need to eliminate crowding."
The reduction of community beds in Wales means that we cannot admit patients from the Emergency Department as quickly as we would like to, resulting in crowded wards and corridor-based care.