As the health service faces yet another winter with all the pressures the season brings, there will be serious concern over the latest waiting times at emergency departments, which show the scale of the difficulties facing staff and patients.
Figures released this week reveal that more than 71,000 people attended A&E units in Northern Ireland in September, a rise of 7.6 per cent on the previous year.
According to the statistics from the Department of Health, almost 60 per cent of those who turn up at emergency departments were treated and discharged or admitted within four hours of arrival.
This compared to 66 per cent in September 2018.
The number of patients waiting longer than 12 hours increased from 1,714 to 3,482, which is particularly worrying.
In September this year, Craigavon Area Hospital was found to have the longest average waiting time spent in an emergency department from arrival to admission while the Royal Belfast Hospital for Sick Children had the shortest average wait.
There will always be variations in waiting times of course, but the overall picture is one of a worsening situation with hospitals struggling to cope.
Winter is always a major challenge and with staff shortages and increased demand it is inevitable that many patients will face lengthy waits for treatment.
It is important that people take steps to protect their own health and lessen the strain on the health service.
Adults and children are being urged by health professionals to get the flu vaccine while anyone with symptoms of a cold or flu should take steps to reduce the spread of illness including observing good hand hygiene.
People with non-urgent conditions are also encouraged to get advice from a primary care health professional rather than turning up at hospital, although it has to be acknowledged that GP practices are also under immense pressure and this is also a concern.
The absence of an executive is clearly a key issue although it must be accepted that the health service experienced considerable difficulties while Stormont was in operation.
Health officials are due to publish an initial report in the new year as part of a review of urgent and emergency care.
There is no doubt that change is needed to tackle the serious and long term problems facing the health service in Northern Ireland.
