The latest emergency care figures show that patients and staff in Northern Ireland's A&Es are facing a "serious situation of deteriorating performance and conditions".
Department of Health figures for April to June 2021, show that more than 67,857 people attended emergency departments around in June, a 25 per cent increase on June 2020.
The figures also show that in the same month, almost 54 per cent of patients attending A&Es were treated and discharged or admitted within four hours - eleven per cent less than June 2020.
Furthermore, the median waiting time for those admitted into hospital was nine hours.
The figures for first three months of 2021 represent the worst four-hour performance on record for Northern Ireland.
While in June 2021, 5,488 patients in EDs waited more than 12 hours - the second worst performance on record.
Dr Paul Kerr, Vice-President of the Royal College of Emergency Medicine, said the figures showed "patients and staff face a serious situation of deteriorating performance and conditions.
"This is posing a threat to patient safety and staff wellbeing," he said.
"Ambulances are waiting longer to offload, and patients are suffering prolonged delays in being assessed and treated, with those needing to be admitted experiencing the worst waits.
"The waiting time to initial assessment continues to rise and, very concerningly, many patients are not waiting to be seen and leaving without assessment. The percentage of patients commencing treatment within two hours of assessment has also declined significantly".
Dr Kerr said severe crowding is happening in "all departments, and it is completely unacceptable that the median average wait for admission is nine hours.
"Not only is this bad for patients but it’s a truly demoralising picture for an exhausted workforce, who continue to do their very best in difficult circumstances," he said.
"Covid numbers have not yet stabilised, and admissions are rising again causing serious concern".
He added: "Without an expansion of staffed bed capacity there is only so much EDs can do - patients will continue to have a rough time and the health service will see waiting lists for operations grow ever longer.
"It is vital that the Department of Health work to find ways of enabling hospitals to free up as much capacity as possible ahead of the winter and whole system solutions are vital if performance is to be improved," he said.
