NHS Providers, the body that represents trusts, says several factors, including Accident and Emergency waiting times and staff shortages, suggest problems for hospitals in the months ahead. At Northern Devon Healthcare NHS Trust, A and E waiting times are already worse than last year. Between April and September, 25,037 people attended an emergency department, with 81 per cent being admitted, transferred or discharged within four hours. The government target is 95 per cent. That figure is lower than the same period in 2017, when 84% of patients were seen within four hours. Across England, the percentage of people dealt with within the time limit dropped by 1% since last year, to 84% in 2018. NHS Providers believes this indicates the coming winter is likely to put more strain on trusts than the last. Jill Canning, deputy chief operating officer at Northern Devon Healthcare NHS Trust, said health services across Devon would be working closely with social care providers to put plans in place for the winter and prepare for the expected rise in demand. She said: Attendances at emergency departments across Devon have been extremely high in recent months, and the highest on record in some areas. Northern Devon is no different. As always, our staff have been fantastic, working flexibly to make sure that our patients receive the best possible care. We also have an internal staff bank and staff have been picking up extra shifts where necessary. It is important that patients continue to receive timely, high-quality care when our services are busy, and health services across Devon have been working closely together with social care to put plans in place for winter and to prepare for the expected rise in demand. The trust has stressed the important of choosing the correct service as a way of reducing pressure on emergency departments, including attending minor injuries units, getting advice and medication from a pharmacy, and making use of GP appointments and NHS 111.