Closures and cutbacks lead to trolley-laden hallways
Belfast's Royal Victoria Hospital became the main hub of emergency care in the city after the closure of the City Hospital's A&E in 2011.
Patient numbers also increased at the emergency department at the Ulster Hospital in Dundonald as the City's patients were diverted.
The pressures increased until in November 2012 almost all of the emergency medicine consultants in the Belfast Health Trust were so concerned they took the unprecedented step of speaking publicly about their concerns over the safety of Emergency Departments in Belfast.
But the concerns continued.
On January 4 last year, opening hours at the emergency departments at the Lagan Valley Hospital in Lisburn and the Downe Hospital were cut. From that date, both emergency departments were closed on Saturday and Sunday and operated from 8am to 8pm Monday to Friday.
On January 8, a major incident was declared at the Royal's emergency department due to a large backlog of patients at the emergency department.
Additional staff had to be called in and extra beds opened to relieve pressure on the unit as staff described being at "breaking point".
At one stage, 42 people were waiting on trolleys and staff described the situation as "horrendous".
In February, there was another crisis when one night saw 96 patients on trolleys awaiting for admission. Staff members and health union officials spoke of the "nightmare" that faced the patients, the staff and management as the number of patients grew.
In July, Dr Sinead Campbell-Grey resigned her top job as clinical lead at the Royal's emergency department because of concerns at "system failures" that led to overcrowding in the unit.
Later that month, it emerged that 190 people had to wait for more 12 hours to be treated at the emergency department at the Royal in June - usually one of the quietest months of the year.
There was another major peak at the Royal's emergency department in August when more than 100 people were waiting to be seen, with 20 patients on trollies waiting to be admitted.
A lack of beds was then blamed for the problem.
Northern Ireland's Health Service is also facing significant budget cutbacks, a situation which has added to concerns about the future of emergency care.