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Doctors are having to choose which "very sick people" they prioritise because of the pressures on Northern Ireland's emergency departments, the Royal College of Emergency Medicine (RCEM) has said.
Department of Health statistics for the first three months of this year show that no ED achieved targets for seeing patients within the four hour and 12 hour benchmarks.
The RCEM said, so far, the figures for 2026 are "the worst they have ever been" and described the state of emergency departments in Northern Ireland as "utterly horrifying".
Speaking on Friday, Dr Michael Perry said the environment staff are working in was making their jobs very difficult.
Dr Perry said a long-term plan is needed to address the "perma-crisis" in emergency departments.
"We're basically pleading with our policy makers and our elected representatives in our government to allow us to do our jobs," he told Good Morning Ulster.
"Don't put us in this position where we have to choose out of two very sick people who we prioritise," he sai.
Dr Perry said the nursing staff turnover that we have in our emergency departments is "vast and it is largely to do with the environment that they work in".
"I've had staff very distressed where something's happened, they have tried their best to deliver the best care that they can, but because of the environment they're being forced to work in something adverse has happened.
Dr Perry said if the executive agreed a multi-year budget it "would allow a plan to be put in place to actually tackle this, rather than stumbling on through the same perma-crisis year on year.
Dr Michael Perry said emergency department staff are working in a difficult environment
How long did patients spend in A&E?
Dr Perry said while there is a "narrative" that problems in emergency departments exist across the UK, Northern Ireland is "by far the outlier".
The figures showed that patients spent an average of 21 and a half hours in Altnagelvin's emergency department last month before being admitted to the Londonderry hospital.
There were also waits of more than 20 hours in the Causeway ED in Coleraine for people who were later admitted to hospital wards.
More than 72,000 people attended emergency departments in Northern Ireland last month.
Those who were later admitted to hospital spent three times longer in EDs than those treated and discharged.
It details information on the time spent in EDs during each of these months including the monthly performance against the DoH emergency care waiting times target for EDs and the time waited for key milestones during a patient's journey through ED, whilst they are being cared for in an ED, including the time to triage and time to start of treatment.
