Bosses at Crewe's Leighton Hospital say they are determined to get to grips with an increasing demand for A&E, as performance continues to decline.
There were 700 more admissions last November than the year before - with a new low of 72 percent dealt with in 4 hours, well below the national target of 95 per cent.
The A&E expanded on December 16 with eight more cubicles for the most patients with the most severe injuries – but board members insist the department now needs more staff to support the rising demand.
Lorraine Butcher, non-executive director at the trust, said: “It just feels as though we’re not seeing anything change – we’re going to have this conversation each year for the foreseeable future.
“Can we just keep expanding? We can’t, can we? It’s the balloon going up.”
James Sumner, chief executive, added: “This is our biggest issue, frankly. Everything stems from this – financial challenges, workforce challenges.
“We still haven’t got some of the staffing levels that we need at the front door.
“Even with the new physical estate, we don’t have any more doctors than we had when we opened it, so that’s the challenge.”
The trust oversees the emergency department and urgent care unit at Leighton Hospital, in Crewe, plus the minor injuries unit at Victoria Infirmary, in Northwich.
Figures released at Monday’s board meeting show that there were 8,154 attendances across the three sites in November 2019 – the most recent figures available.
That figure is an increase of 709 over the 7,445 that attended the three sites in November 2018.
But Chris Oliver, chief operating officer at the trust, told the board that admissions had remained at a similar level for the urgent care unit and Victoria Infirmary, with the growth coming from Leighton’s emergency department.
Chairman Dennis Dunn admitted the trust is yet to understand what is behind the growth – whether it is down to an increase in population or an issue in the health system.
He said: “I think it is reasonable to expect that demand will continue to grow.
“The critical thing for us as a trust to really understand is what is driving expediential growth here, because when you compare us with others in the north, we are more than double what some other trusts are experiencing.”
Out of the six performance targets the trust is set, the four-hour A&E wait was the only one that was missed in November.
While the A&E expansion is not expected to improve the department’s performance against the target, the trust board was pleased with the impact it has had in reducing the number of patients waiting in corridors.
Mr Sumner added: “It really is a significantly improved facility.
“I will suspect that during the winter period it will play a significant part in trying to maintain privacy and dignity for people – that was the key ambition.
“You could see on the faces of the staff when it opened, it really lifted the spirits and made a big difference in terms of their working environment.”
Further proposals to improve Leighton’s A&E department could be brought forward this spring, Mr Sumner added.