Tens of thousands of patients are continuing to spend unacceptably long waits in A&E departments across Wales, latest figures have revealed.
Doctors in emergency medicine claim the pressures on the service are now "year-round" and not just the winter.
The current target set by Welsh Government is for 95% of patients to spend four hours or less in A&E from arrival until admission, transfer or discharge.
It also wants no patients to be in the department for 12 hours or more.
However, latest data showed that only 77.9% of patients were in A&E for four hours or less in June, which equates to 68,577 people out of 88,042.
In some hospitals in Wales barely half of patients were seen within the four-hour target.
And 4,057 ( 4.6% ) patients spent 12 hours or more in emergency care in June, a figure which experts claim could be detrimental to their care.
We have taken an in-depth look at the best and worst-performing emergency departments in Wales, assessed the main causes for these lengthy waits and analysed what needs to be done to improve them.
Wrexham Maelor Hospital, run by Betsi Cadwaladr University Health Board, only managed to get 51% of patients in and out of A&E in four hours or less - the worst in Wales by some distance.
Ysbyty Glan Clwyd ( 60.1% ) in Bodelwyddan, Denbighshire, and Morriston Hospital in Swansea ( 63.9% ) made up the rest of the bottom three.
At the other end of the scale, the Royal Glamorgan Hospital in Llantrisant had the best four-hour performance - despite the fact ambulance crews are told to drop off their patients straight into the unit, rather than waiting outside, so they can immediately respond to other calls.
Percentage of patients spending four hours or less in all of Wales' A&E departments
June 2019: 77.9%
May 2019: 78%
April 2019: 76.4%
March 2019: 78.7%
February 2019: 79%
January 2019: 77.2%
December 2018: 77.8%
November 2018: 80.1%
October 2018: 80%
June 2018: 83.3%
Summer months no better
Despite summer being viewed as a more "manageable" period for the emergency services than winter, the A&E figures do not appear to reflect this.
In fact, performance against the four-hour target was on a par or better during the height of winter than it was in June, even though there were more patients coming through the doors.
And more concerning still is the fact the figures for June 2019 ( 77.9% ) were substantially worse than June 2018 ( 83.3% ).
Ysbyty Glan Clwyd had the highest percentage of patients spending 12 hours or more in A&E in June ( 12.4% ), followed by Withybush ( 11.2% ) in Haverfordwest and Wrexham Maelor (10.1% ).
The University Hospital of Wales ( 0.7% ) in Cardiff and the Royal Glamorgan ( 0.8% ) had the lowest percentage of patients spending 12 hours or more in these units before being moved elsewhere.
And again, when comparing the situation with 12 months earlier, figures show that A&E performance is continuing to slip, with 96.9% being seen in 12 hours or less in June 2018 compared with 95.4% in June 2019.
Nurses of the NHS on change over the decades
Responding to the figures, a Welsh Government spokesman said: " Like the rest of the UK, our emergency departments are experiencing considerable pressure all year round.
"There are many reasons for this including increasing demand and the more complex needs of older, frail people being treated in emergency departments.
"Our long term strategy, A Healthier Wales, aims to transform the way we deliver health and social services to meet future demand. We are working with the NHS to reduce the pressure on emergency departments and deliver improvements in performance.
"This includes helping more people to remain independent at home, focusing on vulnerable groups who need care the most and increasing capacity.”
