Winter has already arrived for healthcare staff and patients in Stoke-on Trent and Staffordshire according to hospital bosses.

University Hospitals of North Midlands (UHNM) NHS Trust, which runs Royal Stoke and Stafford's County Hospital, has seen a surge in patients with Covid as well as drop in its A&E waiting time performance in recent weeks.

In September almost 70% of patients were admitted, transferred or discharged within four hours of arrival at A&E. But this fell to just over 60% at the end of October, members of UHNM's board heard at their meeting on Wednesday.

A new clinical decision unit has been created in an existing part of the emergency department and was due to "go live" on October 27, providing space for eight "ambulatory" (able to walk) patients who are waiting for diagnostic investigations and tests. But a leak in the roof meant that this opening has been delayed until Monday, November 13, board members heard.

In October, 60% of patients were admitted, transferred or discharged within four hours of arrival at A&E (SWNS).

The trust's winter surge plan was presented to the board at its October meeting. Last month saw "significant pressure" across the trust's hospitals, which led to a business continuity incident being declared.

UHNM's chief executive Tracy Bullock said in her report to Wednesday's board meeting: "We were able to take a number of quick steps to help improve patient flow and to decongest our emergency department, in order to keep our patients safe. It is becoming increasingly evident that we have patients in our beds that do not need acute care and could likely access other services that either we or our system partners have available.

"Together as a system we will ensure awareness of these services and how to access them and to support this we are holding two 'Getting to Know You' drop-in sessions at Royal Stoke and County Hospital next month. Further communication will be published over the coming weeks.

"Also to assist in ensuring people receive the right care in the right place we commenced a test of change (TOC) on the 23rd October on our Frail Elderly Assessment Unit (FEAU). (This) aims to redirect appropriate patients to the most suitable service.

Winter has already arrived for healthcare staff and patients in Stoke-on-Trent, according to hospital bosses (SWNS).

"The vast majority will be redirected to services outside of the acute hospital and discussions to date indicate this is going very well. Phase two of this TOC will see ward 80 in the West Building become nurse and therapy led care, therefore releasing our elderly care physicians to review patients at the front door in assessment areas such as FEAU."

Speaking at Wednesday's meeting she added: "We have had a challenging October and we are firmly in winter in terms of how the NHS is facing the impact. We did see quite a sharp and sudden increase in Covid, but that seemed to plateau fairly quickly and has come down to 70-odd patients last time I looked, which is good news because it was more than double that just a couple of weeks ago.

"We have single numbers of patients with flu. We are not seeing big numbers yet but we are very early in the winter period.

"Things are starting to build up. We have a bed capacity gap we know about through the winter plan and we do expect it to be challenging."

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