Toby Lewis, chief executive of the trust which runs Sandwell and City hospitals, said there had been a "doubling of unacceptable waits in the last five weeks" in A&E and that the situation had been compounded by a shocking bed occupancy rate of "99-101 per cent".
The crisis is causing major concern among health bosses ahead of the busy winter period when pressure normally ramps up. Emergency plans are now being drawn up to try and ease the pressure.
Mr Lewis said it was the "toughest situation" he had witnessed and that a "huge turnaround" was needed over the coming weeks to bring it under control. But he added he was "absolutely" confident it could be achieved.
The two hospitals are having to cope at full capacity for longer than expected due to the delays on building the new Midland Metropolitan Hospital, which is due to open in 2022.
A total of 81 per cent of patients were seen within four hours during August, the most recent figures available, down on the national 95 per cent target. Problems appear to have worsened since then.
Mr Lewis said on Twitter: "Met today with 10 people trying to help our A&E and emergency care system to cope and then thrive. Toughest situation I can remember in 25 years of service. But we’re resolute, we can succeed.
3/3 but dreadful pressure on EDs and bed occupancy of 99-101%. Long long waits to be seen. Doubling of unacceptable waits in last five weeks. So huge turnaround needed in November. Absolutely know we can do it. And we know we will be safer when we do. @SWBHnhs— Toby Lewis (@TobyLewis_SWBH) October 15, 2019
"We have high flu vaccination rates, great partnering with WMAS on ambulance turnaround. Strengths to build on. Best or almost best in region in each of these domains.
"But dreadful pressure on EDs and bed occupancy of 99-101 per cent. Long long waits to be seen. Doubling of unacceptable waits in last five weeks. So huge turnaround needed in November. Absolutely know we can do it. And we know we will be safer when we do."
The resumption of work on the Midland Met was signed off by the Government last week but both Sandwell and City hospitals must get through to 2022.