Health Minister Edwin Poots has warned he is “monitoring closely” the situation at two Belfast accident and emergency units after consultants raised fears over staff and patient safety.
Mr Poots was responding after the clinical director of the Royal Victoria Hospital's A&E department stepped aside — understood to be over concerns about how the units are being run.
A number of consultants in the Belfast Health Trust have also written to management raising worries about the safety of the emergency departments.
The revelations have led to the chair of Stormont’s health committee, Sue Ramsey, to say the claims indicate staff are not receiving “sufficient support from senior management”.
The SDLP has also called on the Health Minister to “give assurances” winter services will meet demands.
The Belfast Trust, however, has said it is “confident” it can provide services throughout the winter period.
It is understood Dr Russell McLaughlin, who had been clinical director of the Royal's A&E department for four years, feared additional workloads had stretched staff too far and were affecting how patients were being treated.
Dr McLaughlin will continue working as an emergency medicine consultant and take a 20% cut in his salary.
The City Hospital A&E unit shut last November and it was reported that hospitals nearby would have to cope with an extra 40,000 patients attending their emergency departments.
The reason for the closure — described as temporary at the time — was due to a shortage of senior staff.
The Royal then became the main hub of emergency care in Belfast.
A spokeswoman for the Belfast Trust claimed the number of attendances in the RVH A&E department is up 30% since the City Hospital A&E closed.
Figures provided by the trust showed in September 2011 that there were 5,239 attendances at the RVH A&E — in the same period this year it jumped to 6,924.
And, in October 2011, the RVH A&E had 5,125 patients, but this rose to 7,038 in 2012.
But it said steps have been taken to address the issue including nine extra cubicles being added within the RVH A&E. And Dr Tony Stevens, medical director of the Belfast Trust, said concerns have now been addressed.
“Our consultants, our clinical teams have been working over the summer to get ready for this winter,” he told the BBC.
“There's been a huge amount of forward planning.
“We've opened a direct admission unit for GPs, we've expanded the size of our medical admission unit.”
In a statement, the Department of Health said it is “monitoring the situation closely”.
“It is important to state that there has been a very significant reduction in the Belfast Trust in the numbers of breaches of the 12-hour standard.”
From March to October this year, provisional figures provided by the department show that the trust has reduced its 12-hour breaches from 201 to three.
Asked if the minister was concerned about mounting pressures on staff at the hospitals, the statement said Mr Poots “recognises the commitment of hospital staff to delivering the best possible service to patients”.
SDLP health spokesperson Conall McDevitt said despite “special measures” being in place for some time at the Belfast Trust “significant problems still remain”.
A spokeswoman for the trust said it is working closely with the Health and Social Care Board in providing additional resources over the winter.
A spokeswoman for the trust said: “We are confident with all the improvements in place for patient care that we can provide the reassurance that the winter ahead will be well managed with the dedication and engagement of all staff in the Belfast Trust. In the emergency department itself we have been working with staff to ensure that we take full account of the pressures being experienced.”