North East Ambulance Service bosses warned that, though ambulance handover delays had improved in January, they will continue to work hard to avoid the issue returning next winter.
NEAS' chief executive Helen Ray told the organisation's board that the new NHS Integrated Care System - now led by recently appointed chief exec Sam Allen - was working with the service and hospital trusts around the region to ensure systems are in place to prevent "significant problems" returning.
And medical director Dr Matthew Beattie explained that the improvements seen in January were largely due to a fall in demand from patients.
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In December, the board heard how handover delays had "reached the highest levels recorded", while NHS England has written to every NHS Trust in the country highlighting the issue and demanding improvements.
He said there was "a significant piece of work" ongoing on the issue at a regional level.
"We have had significant problems all through the winter period and although performance is improving that's largely related to other factors," he said.
"We are keen for that work to continue so that we are in a robust position going into winter next year.
"It's a problem year after year - pressures build at hospitals, there are long waits and then we end up with fewer resources to attend other calls."
Dr Beattie said that addressing handover delays "remains a priority" and warned: "We could be back in a position where significant delays are causing problems at particular trusts very quickly."
In January, average handover time was 23 minutes and 19 seconds - but there remained 143 people across the region who waited more than two hours for an ambulance handover to hospital.
In recent months the picture has varied widely across the North East's hospitals.
In the final three months of 2021, the RVI in Newcastle saw the lowest average handover time - just 15 minutes and 54 seconds - while the longest waits were at James Cook University Hospital in Middlesbrough (39 minutes, 21 seconds) and Darlington Memorial (31 minutes, 26 seconds).
The University Hospital of North Durham saw handover waits clock in at just under half an hour (29 minutes, one second), while all of Sunderland Royal (26 minutes, 35 seconds), North Tees Hospital (24 minutes, 11 seconds), the Northumbria Specialist Emergency Care Hospital (23 minutes, 32 seconds), South Tyneside District Hospital (23 minutes, five seconds) and the Queen Elizabeth Hospital in Gateshead (18 minutes, 13 seconds) exceed the national guideline of 15 minutes.
The board also heard that NEAS performance levels had improved more generally in January - with chief operating officer Paul Liversidge saying: "I can't remember the last time I have been so positive about our outcomes.
"It's a really positive report that we're seeing coming through. We have seen improvements in response times and in call answer times, and though we have not necessarily been meeting all the national standards we have been knocking on the door."
Trust Chair Peter Strachan joined Ms Ray in highlighting the importance of recognising the work done by NEAS staff on a daily basis. Mr Strachan said he was conscious of not forgetting the often difficult situations facing staff.
He said: "I would like to acknowledge the efforts that our teams put in day in, day out and night in, night out. We recognise how extremely challenging it has been out there over the last two years."
