Hospital bosses are stepping up plans to ensure key targets are met in a bid to avoid potential penalty fines which could have a severe financial impact.

Directors at Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) yesterday outlined plans for how and when targets would be met in areas including A&E, cancer, referral to treatment, and other diagnostics - as a busy winter period approaches.

It comes as a report by the Royal College of Emergency Medicine showed waiting times in A&E departments are getting worse across the country, as patient demand increases,

Last month Norfolk's three hospital trusts all missed the A&E target (95pc of patients waiting four hours or less to be seen, treated, and admitted/discharged), with NNUH achieving 87pc.

James Paget University Hospitals NHS Foundation Trust achieved 94.02pc in October while Queen Elizabeth Hospital King's Lynn NHS Foundation Trust managed 87.33pc.

At NNUH delays to assessment in the A&E department and a lack of available beds in wards are the two main reasons for the target continuing to be missed.

But NNUH's interim chief operating officer Richard Parker said the trust 'expected' to hit the 95pc target by April next year.

He said the trust planned to set up an 'integrated discharge hub' where staff focus specifically on working with the right social care or community care partners to prevent medically fit patients from becoming so-called bed-blockers.

Nationally the figure for patients waiting four hours or less at A&E has sunk to 88pc, according to the Royal College of Emergency Medicine's study.

Meanwhile NNUH has made hitting the 62-day wait for cancer treatment target its main priority, but October's figure (76pc) showed it was still a way of achieving the 85pc target.

Part of the trust's plan to improve waiting times for patients needing non-urgent treatment after referral is to open a new temporary operating theatre in December, which will help reduce the patient backlog.

The theatre, which will be provided by private healthcare firm Vanguard, can treat up to 30 patients every week and will be used for two years.

It consists of an anaesthetic room, theatre, recovery bay and eight trolley bays.

Surgeries such as hernia repairs, urology, biopsies, and hand operations are among the treatments the unit will provide.

Mr Parker said: 'The theatre provides the hospital with vital temporary capacity.

'It allows us to meet demand without having to lay out the time or capital to build new facilities.

'I think that the use of this kind of innovative technology really displays the kind of flexibility the hospital is achieving to continue to offer the best standards of care.'

He said the trust predicted the 'recovery' to be complete by next summer but added the commissioners wanted this achieved by March.

The trust says it will use the money generated from the surgeries to cover the cost of the theatre.

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Contact our health correspondent by emailing nicholas.carding@archant.co.uk or call the newsroom on 07501 481521.