Stretched medics at Blackpool Victoria Hospital treated thousands more patients in December.
New figures show the extraordinary strain staff are under as the surge in demand saw waiting times rise at A&E.
It comes after The Gazette revealed earlier this month how record sickness levels have left bosses struggling to cover shifts, with the emergency room proving particularly tricky to keep running at full speed.
Chief executive Kevin McGee praised the “extraordinary” efforts of Vic staff this winter, faced with the sharp rise in patients at what is already an extremely busy time of year.
More than half of patients at A&E waited more than four hours to be admitted, transferred or discharged – the government’s benchmark standard – in December.
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Just 44.2 per cent of people waited four hours or less in the emergency room last month. Nationally, only Lancashire Teaching Hospitals, the trust that runs Royal Preston Hospital, performed worse, at 43.4 per cent.
However, the overall performance – which includes less serious cases, such as patients visiting the urgent care centre or walk-in centres – was among the best in the North West.
With 81.9 per cent of the 18,950 people arriving for treatment in December being seen within the four hour target, just two North West trusts with A&E departments performed better.
Although the figure was down from 87 per cent in December 2018, embattled medics saw an extra 2,103 patients over the course of the month – a 12.5 per cent increase.
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Mr McGee said: “Like many NHS organisations across the UK, our system is under significant pressure, but staff are working very hard to make sure we continue to provide the urgent and emergency care that our community needs over the winter period.
“We are proud of their extraordinary efforts to provide safe care to our patients in very challenging circumstances.
“We currently have a high number of very ill people attending our emergency department who require admission to hospital, which puts pressure on the availability of beds.
“One of the challenges we face is having a suitable place to discharge a patient to and this can sometimes cause a lack of flow throughout the hospital.
“We continue to work closely with our partners to make sure out of hospital care is ready when our patients are medically fit to be discharged.
“We are grateful to those in our community who have utilised other appropriate healthcare provision for minor ailments.
“We would ask for their continued support in using local pharmacists, GPs or calling NHS 111 where appropriate.”
Data published by the NHS shows December saw a record number of A&E attendances and ambulance call-outs nationally.
Across England, 79.8 per cent of A&E patients were seen within four hours last month – the worst figure on record and set against a target of 95%.
The monthly performance statistics show there were 2,181,024 attendances last month - a 6.5 per cent rise from December 2018.
Downing Street said winter was “always challenging” for the NHS.
Niall Dickson, chief executive of the NHS Confederation, said the figures “represent a cry of despair from a service that is delivering remarkable care to millions of patients, but is under enormous pressure”.
Katherine Henderson, president of the Royal College of Emergency Medicine, said: “The NHS is struggling to escape its spiral of decline.
“With a record low in terms of four-hour performance and highest ever number of 12-hour waits, this will have been a miserable Christmas period for many patients and staff alike.”
Nuffield Trust chief economist Professor John Appleby said: “These would be dire performance figures for any December but what’s worrying is that we are still awaiting the truly cold winter weather that we know will plunge the NHS into further problems.”
The British Medical Association called the winter figures “truly alarming”, and asked: “How many wake-up calls does the Government need?”
The NHS figures also show that ambulances attended 790,294 incidents in December – the busiest month on record and a 5.3 per cent increase from the same month the previous year.
Professor Stephen Powis, NHS medical director, said: “We have got more hospital beds open than last winter, but flu has come early and is around twice as high as this time last year.
“For the public there is still time to get your flu jab, and remember to use the free NHS 111 phone and online service and your local pharmacist.”
The Prime Minister’s official spokesman said: “Over 2m people attended A&E last month. That means that dedicated staff cared for over 70,000 people every day - the highest ever for December.
“We have invested an extra £240m in adult social care to get patients home quicker and an extra £1bn for immediate hospital upgrades.
“Improving the NHS is a priority of the Prime Minister and a record cash boost worth £33.9bn extra by 2023/24 is being enshrined in law by the Government.”