Hospital trust is facing fine for struggling A&E

The department, which is currently seeing 40,000 more patients than it was originally designed to take each year, has been overworked all winter with patient numbers soaring. And now it is set to be fined for the best part of £1m when new guidelines come into force in Apil. The trust will be fined for its rate of getting ambulances back out onto the road after patients have been dropped off.

The Clinical Commissioning Group (CCG), which helps run healthcare budgets in the region, will dish out the fine, which is set at £1,000 if an ambulance waits at the hospital for more than an hour. For every 30 minutes the fine is £300 and on current performance the total the Royal Wolverhampton NHS Trust would have to pay is up to £750,000.

Trust chief executive David Loughton called the severity of the rates being charged as "madness", but admitted the accident and emergency department was underperforming. He said: "In terms of A&E the performance is not where it should be.

"The department was designed to have 40,000 fewer patients per year than we're trying to push through it.But you cannot criticise the staff.

"Our performance is very good and £750,000 would fund a medical ward with 30 nurses for nine months.

"Was that the intention of these fines? It's madness." Last month the CCG fined the trust £17,000 for failing to hit waiting time targets in A&E and at the time Mr Loughton admitted the department was unfit for purpose.

In 2012 the trust spent £1m on upgrading the department and also announced plans to create a new £25m A&E, which is due to open in 2015.

Mr Loughton admitted the situation could be repeated annually until then.

Gwen Nuttall, chief operating officer for the trust, said: "January was a challenging months for the trust. Clearly A&E has been a significant challenge. The ambulance fines could potentially have a significant financial impact." Weekly attendances at New Cross have shot up in the past year, with an increase of 5,261 patients seen at A&E during May to December compared to the previous year.

Around 350 patients descend on the department each day The number of ambulances arriving at New Cross has also sharply increased by around 12 per cent between October and December last year, compared to a four per cent rise seen in other areas of the West Midlands. It is also expected the fallout from the Stafford Hospital scandal will lead to a rise in patients choosing to travel to Wolverhampton.