Doctors and nurses at Bradford's hospitals are battling to treat dozens more cases of pneumonia and flu as patients struggle in the winter cold snap.
Ten extra beds have opened at Bradford Royal Infirmary, while 16 extra medical beds and ten additional elderly care beds have been brought into use at St Luke's Hospital.
Since Christmas, a rise in flu-type illnesses and complex conditions like pneumonia is putting pressure on hospital services.
Dr Paul McWhinney, consultant in acute medicine and infectious diseases at Bradford Teaching Hospitals NHS Trust, said: "Patients are staying in hospital longer because we are seeing people with bad pneumonia who are very ill and more difficult to treat.
"The symptoms are breathlessness, high fever, chills and a cough, along with sharp chest pains. They need oxygen and antibiotics by injection with fluids through a drip. It can make even young, fit people very ill although it obviously hits older people harder."
In the first week in December, 544 people were admitted to A&E. From December 30 to January 5, 649 people were admitted as emergencies to Bradford's hospitals - a rise of 20 per cent.
A consultant physician has been employed on a short term contract to cover the winter months and will be in post until March and an extra ambulance for the Trust is now running to cope with demand.
A Trust spokesman said: "There has been a noticeable rise in the number of emergency admissions since Christmas. We also seem this winter to be treating patients with more complex conditions requiring greater time in hospital, thereby adding a new dimension to the situation we normally face.
"As a result of the capacity planning work that takes place throughout the year, we are well prepared for extra demand on services like we are currently experiencing. Bradford's hospitals are geared up for coping with this increase in patients and, although we are now as busy as we have been during the winter, staff are doing a tremendous job in maintaining a full range of services."
No operations have had to be cancelled. The winter plan has been developed in partnership with other health and social care organisations, such as GPs and the ambulance service.
It builds on successful schemes and teamwork in previous years when, in spite of flu outbreaks and a surge in the number of emergency admissions, the hospitals did not postpone any operations.
Other measures in place include increased support from pharmacy, x-ray and therapy teams, a voucher scheme being operated by Bradford Social Services to enable patients to be placed in nursing or residential homes while discharge arrangements are made, such as re-housing.
There is a system to enable the rapid transfer of patients to free beds and rehabilitation beds have been opened in some care homes.
A team is also working in the community to support patients discharged from A&E.
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