A snapshot survey of A&E departments has found patients still endure long waits.

However, managers have claimed that the figures do not tell the whole story.

The worst case found in the survey by the Association of Community Health Councils in England and Wales (ACHCEW) was a 90-year-old woman who waited for over 95 hours on a bed in casualty.

Resources are overstretched in many hospitals and it is the A&E departments that are taking the strain

Peter Walsh, ACHCEW

In the last ever 'casualty watch' before community health councils are abolished, ACHCEW found patients were being "warehoused" in assessment and observation units in A&E.

These units are intended for patients who need monitoring or further tests before doctors decide whether they need to be admitted or discharged.

But ACHCEW said some were being placed in the units simply because there was nowhere else to put them.

'Unacceptable waits'

The organisation carried out its survey of how long patients were waiting in A&E on beds, trolleys or chairs in 167 A&E units across England at 1630BST on Monday 20 May.

The 20 longest waits recorded ranged from 28 to 95 hours.

The 90-year-old woman who had the longest wait was being cared for at United Hospital Aintree NHS had fallen and had pains in her right hip.

Other long waits highlighted by ACHCEW were:

• a 66-year-old man with shortness of breath who waited for a bed for over 47 hours at St Peter's Hospital, Surrey
• an 81-year-old woman who had a swelling after banging her foot who had waited for just over 47 hours, again at Aintree
• a 52-year-old woman with renal failure who waited 39 hours for a bed at Bromley Hospital, south London
• a 78-year-old woman with a fractured arm and head injuries who waited on a trolley for almost 30 hours at the John Radcliffe Hospital, Oxford because there was no bed available

A statement from Aintree Hospitals NHS Trust, which had a total of three cases in the list of 20 longest waits said ACHCEW's figures were inaccurate and should be corrected.

Paul Birrell, the trust chief executive, said the 90-year-old woman was seen by a doctor within an hour of arrival. It was decided she needed to be given treatment to raise her blood sugar levels.

"She was very appropriately referred to the observation ward."

Peter Walsh, director of ACHCEW said waits of more than 24 hours were "clearly unacceptable".

He said: "These figures show that resources are overstretched in many hospitals and it is the A&E departments that are taking the strain.

'Nowhere else for patients'

He added: "What we are finding is that all too often patients are being warehoused in assessment and observation units until an appropriate bed can be found for them elsewhere in the hospital."

A&E departments were simply overstretched, he said.

Some patients endure long waits on trolleys

ACHCEW is calling on the government to publish full data on A&E waits and to tackle discharge delays to free up beds on wards.

A spokesman for the Department of Health said the 77% of people attending A&E were admitted, transferred or discharged within the target maximum wait time of 4 hours - and trolley waits of over 12 hours had been reduced by 50% since 1999.

He said �118m was being invested in reforming A&E and other emergency care process, including access to GPs and social services.

He added: "However, we recognise that a minority of patients still wait too long in A&E."

He said patients were placed in observation or admissions wards when their condition demanded continuous reassessment.

"Often they may be able to be discharged after a certain period of time without being admitted to a ward.

"This is good clinical practice - these wards ensure patients can receive the appropriate care."

Bed shortages

Shadow Secretary of State for Health, Dr Liam Fox MP, said: "Yet again we see that the real health service is very different from the virtual health service as described by ministers.

"In the real NHS vulnerable patients, such as a 90 year old lady, are waiting over 90 hours in casualty."

Such prolonged waits are clearly unacceptable but it only represents the tip of the iceberg

John Heyworth, British Association for Accident and Emergency Medicine

Dr Peter Hawker, chairman of the British Medical Association's consultants' committee said a shortage of beds was the biggest problem faced by hospitals.

"Patients need to be admitted onto a hospital ward, with the care of the appropriate consultant, as soon as possible," he said.

"Until hospitals are able to increase capacity it is vital that the total time spent in A&E is logged accurately to provide a reality check on the pressures at the frontline."

John Heyworth, president of the British Association for Accident and Emergency Medicine, said: "Such prolonged waits are clearly unacceptable but it only represents the tip of the iceberg.

"There are many patients waiting for six, eight or 10 hours in our departments which is far too long."