Northumbria Healthcare is performing well compared to other NHS trusts across the country, but is still missing key targets.
Officials spoke at Northumberland County Council's health and wellbeing board on Thursday and explained that healthcare staff were feeling the pressure after what has been a "relentless" few years.
The trust led the way in the UK for A&E waiting times and referral to treatment times, as well as sitting sixth in the table for diagnostics.
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Speaking at Thursday's meeting, the trust's medical director Alistair Blair said: "A&E attendances are probably at an all time high which I think represents pressures in the system.
"We're doing well compared to our peers but that's not a case of resting on our laurels. We want to absolutely improve where we are.
"It's just to reassure people we're absolutely monitoring this on a weekly basis. Residents in Northumberland are already getting a much better deal than a lot of rest of the NHS.
"I would say that the aggregate position is an NHS that is not performing as well as it did three years ago."
Northumbria saw 114 patients wait more than 60 minutes for an ambulance handover to a hospital, while just 27.6% of handovers were done in 15 minutes or less, compared to a target of 65%. A total of 78.4% were completed in thirty minutes or less, compared to a target of 95%.
In A&E, 90.1% of patients were seen within four hours, with the target being 95%. In terms of diagnostics, 96.8% of patients waited less than six weeks, with the target standing at 99%.
And 82.2% of patients received a referral to treatment pathway within 18 weeks, with the target standing at 92%.
It comes as the annual winter pressures on the health service begin to set in - although it was pointed out that there has been little let-off in terms of numbers this year.
Medical consultant and business unit director for medicine and emergency care Dr Simon Eaton added: "Winter is not new. There is some very well-rehearsed plans and pressures.
"Our workforce didn't see any reprieve over the summer. They're all very stretched, and very tired. We want to make sure we're managing the volume of people who need the care that they need.
"It has been quite relentless over recent years."
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