EMERGENCY care at Worcester's Ronkswood Hospital has been condemned as "poor" after a night of chaos in the A&E department.
Charge nurse Richard Larkin - the most senior nurse on duty in casualty - described conditions as "chaotic" last night as ambulances queued for up to an hour outside the hospital.
Patients were taken to Kidderminster General, Selly Oak in Birmingham and the Alexandra Hospital at Redditch because of a lack of acute beds at Worcester.
The latest chaos came less than a month after the Evening News reported ambulances queuing for more than an hour outside Ronkswood.
"I've worked in Saudi Arabia and Birmingham and I can say this is the most difficult environment I've worked in," said Mr Larkin, a nurse for nine years who has worked at Ronkswood for two.
"Poor standards of care are being offered - the Trust can't deny it. It's been chaotic here tonight."
He said confidentiality regulations prevented him from revealing details of how many patients had been diverted from Worcester or how serious their injuries were.
A spokeswoman for Hereford & Worcester ambulance service said the afternoon and evening had been "horrendously busy".
"Ambulances have been queuing for between 45 minutes and an hour at Ronkswood this evening," she said, as three waited outside the hospital for beds to become available at 8pm.
"We're having to divert casualties from Ronkswood."
A 36-year-old man who fell 10ft from a ladder in Droitwich and suffered neck and spinal injuries was airlifted to the Alexandra Hospital in Redditch.
Meanwhile, casualties from a car accident in Hagley were sent to Kidderminster General, which is being downgraded under a Worcestershire Health Authority strategy entitled Investing in Excellence, but which has 24-hour "doctor-led cover" for A&E.
Nobody from Worcestershire Acute Hospitals NHS Trust was available for comment today.
Last month the Trust blamed the county's social services for not dealing with 'bed-blockers', patients who could be switched to residential care.
Harold Musgrove, the Trust's chairman, claimed 33 beds were being occupied unnecessarily.
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