A temporary ward, more patients treated at home, and extra cubicles in the emergency department.

Those are just three of the ways bosses at the Norfolk and Norwich University Hospital (NNUH) are hoping to stop a repeat of last winter, when ambulances were left queueing outside A&E for hours and patients were forced to wait on trolleys in corridors.

Last winter was widely recognised across the country as one of the worst the health service has ever seen.

All three of the county's hospitals suffered, with then medical director of the James Paget University Hospital (JPUH) in Gorleston saying on his 30 years on call for a labour ward he had 'never experienced difficulty like this'.

But now the NNUH has developed a 'belt and braces' plan.

Papers released ahead of a board meeting at the hospital today (Friday) said between 22 and 40 extra beds would be needed to cope with demand this winter, with an aim to open 42 to be on the safe side.

A temporary modular ward would provide 20 of these, and would be put up by November.

And more escalation space - areas used when beds are full - would be opened in non-clinical space, or in areas used for research, giving another 22 beds.

The number of rapid assessment and treatment cubicles in A&E was to be doubled, from four to eight, to see patients faster.

There would also be a focus on moving patients out of beds faster, with the hope of opening a discharge lounge, where patients ready to leave could be moved to, to free up beds earlier in the day.

And a proposed pilot of treating 30 patients at a time at home, when they are occupying a bed but do not need hospital care, could help free up space.

Under the scheme patients remain the responsibility of their NNUH consultant, but receive their treatment such as long-term antibiotic therapy, or complex wound dressings, at home.

Richard Parker, NNUH chief operating officer, said: 'The whole NHS system experienced very high levels of demand last winter and work has been underway for a number of months to prepare for winter 2018/19. We are working closely with our partners to plan ahead.

'Last winter we put in place an integrated discharge team involving community and social services, older people's emergency department (OPED), children's emergency department expansion, and mental health liaison service.

'This year we are looking to increase capacity with an extra 42 beds and to create a discharge lounge to improve patient flow. We will also be increasing capacity at the emergency department to ensure patients arriving by ambulance are assessed quicker.

'We will also be extending the opening hours of OPED which has been a success and has received really good feedback from patients and families since it opened in December.'

At some points over the winter all three of Norfolk's hospital were put on alert due to the sheer number of patients needing to be treated.

In January the A&E chiefs each signed a letter to the Prime Minister warning safety levels were 'intolerable' amid 'severe and chronic underfunding' of the NHS.