Prime Minister David Cameron has acknowledged hospitals are facing "real difficulties" this winter after figures showed accident and emergency units were failing to hit the target of seeing 95% of patients within four hours.

And Mr Cameron said it was "not good enough" that some hospitals were falling far short of the A&E target.

At the Great Western Hospital routine operations were postponed last week as staff dealt with the backlog of an exceptionally busy weekend in the hospital’s A&E department.

And official figures showed that GWH was not meeting a national benchmark for seeing patients in A&E. NHS England aims for 95 per cent of patients going to A&E to be seen within four hours, but GWH was dealing with 83.4 per cent in that time.

Today Mr Cameron said the Government was taking action to improve services in the community in an effort to ease the pressures on A&E, while £700 million extra had been provided to help hospitals cope.

Asked if the NHS was in "crisis" he said: "I accept that our hospitals are facing some real difficulties this winter but we should start from the point that they come into this winter with more money, more doctors, more nurses than there have ever been in our NHS in history.

"But I'm not denying, of course, there are pressures."

He told BBC Sussex: "What we have got to do is make sure that the money gets to the front line, that those extra doctors and nurses we paid for are hired and also we help hospitals to cope.

"In the longer term we have got to do more to make services available in the community and have more seven-day opening, for instance, for GPs to help people use that option as well as the A&E option."

Figures last week showed A&E units in England saw 86.7% of patients within four hours in the week ending January 4, failing to meet the 95% target.

The first set of weekly figures issued this year show that for "type 1" major A&E departments, just 79.8% of patients were dealt with within four hours.

Asked about the performance of the Royal Sussex hospital in Brighton, which failed to hit the target, Mr Cameron said: "It's not good enough. Our target is that 95% of people should be seen in A&E within four hours and in the year to date in Brighton the figure is 85%, so that's not good enough.

"There are hospitals in the region that are meeting the 95% target, so it can be done."

The extra £700 million announced to help the NHS this winter was "only a short-term answer", he added.

"In the longer-term we need to make sure that our services in the community are better.

"Many of the people who go to A&E, quite understandably, are frail and elderly people who want help.

"They would be better looked after if we had more services in the community."

Brighton A&E consultant Rob Galloway last week wrote an open letter to Mr Cameron saying the Prime Minister was too embarrassed to admit there was a crisis in the NHS.

Dr Galloway said it was considered a "good shift" if "no member of staff is in tears and no-one dies in the corridor on our watch".

Mr Cameron admitted there was a "problem" in A&E caused by the number of additional patients attending emergency departments.

He said: "I think that people working in our A&E departments have performed magnificently over this Christmas and new year period and obviously they are facing immense pressures.

"The numbers visiting A&E have gone up very markedly over the last year, something like 40,000 more people a week are going and that has created quite a lot of pressure."

Asked if he thought Dr Galloway was exaggerating, the Prime Minister said the Royal Sussex had seen 85% of people within four hours in the year to date.

He added that he would reply to the letter from Dr Galloway.

"Clearly they are under pressure, the numbers are very great and the staff are doing a fantastic job," Mr Cameron said. "We need to make sure the money is getting to the front line.

"I don't want to quibble with what people are saying, there are very great pressures, we need to help people meet that pressure."

Mr Cameron added: "When you have got a target of wanting to see 95% of patients within four hours and you are not doing that in every hospital - some hospitals are still achieving it but many hospitals aren't achieving it - clearly there is a problem.

"The problem, I think, fundamentally is caused by the additional number of people going to A&E."