Almost half of casualty patients are waiting longer than the Government's four-hour target.

Waits of eight to 12 hours are not unusual for people in accident and emergency at the Royal Sussex County Hospital in Brighton.

Hospital bosses say a combination of bed blocking, high patient numbers and staff shortages are contributing to the pressures.

The Department of Health says by the end of March at least 90 per cent of patients arriving at A&E should be dealt with in four hours.

A survey by the British Medical Association (BMA) yesterday revealed many hospitals in England are not regularly meeting the four-hour standard.

Brighton and Sussex University Hospitals NHS Trust is hitting the target about 55 per cent of the time.

The trust is responsible for A&E departments at the Royal Sussex and Princess Royal Hospital in Haywards Heath.

Chief executive Stuart Welling has already warned the trust board there is a good chance the A&E target for next March will not be met at the Royal Sussex.

More than 100 of the trust's beds are taken up with patients who are ready to be discharged but cannot leave because there is either no nursing home place for them or a package of home care has not been arranged.

This has a knock-on effect as patients in casualty have to wait until a bed on a ward becomes available.

It also means non-emergency operations are cancelled.

A trust spokesman said: "This is a problem that involves the whole of the health community.

"A lot of work is being done on developing intermediate care services for patients so they get the help and support they need without having to stay in hospital."

The A&E department at Worthing Hospital is one of only a handful in England taking part in a major study investigating how to improve waiting times.

The results are expected to be rolled out to all casualty departments in the next five years.

The BMA survey found that in one in five departments, patients had waited for more than 24 hours to be admitted.

Half the consultants surveyed did not accept the claim that most people who arrived in A&E spent four hours or less in the departments.

The report also asked the consultants if they felt things had changed in the last year but only 26 per cent said it had improved.

The report, called Waits and Measures: Improving Emergency Care for Today's Patients, said increasing the number of beds would be the most important step to help cut waiting times.