Senior North East doctor's fears over A&E pressures
A senior doctor said the traditional way of staffing hospital accident and emergency departments is "not sustainable" or "fit for purpose".
Bob Jarman, lead accident and emergency consultant at Gateshead's Queen Elizabeth Hospital, said they were under constant pressure.
He said hospitals could no longer be "Monday to Friday" institutions.
A review of emergency provision in hospitals is being carried out by NHS Medical Director Prof Sir Bruce Keogh.
Speaking to BBC Inside Out on one day when a total of 169 patients were treated at the A&E department, Dr Jarman was due on shift until 15:00 but on call for 48 hours.
He said: "It will take me many days to stop feeling tired because it's the medical stress as well as the physical thing of the hard shifts but at the end of the day I have done this for years so I don't know any other way.
"I think in the future it's unsustainable. With the workload I would rather that we had a consultant up to midnight."
He described most days as "pretty much full-on", often working from 0800 until well after midnight.
"We tend to find we will get an hour where it's great and then we will get an hour where we will get 10 ambulances with sick people in and that might happen for two or three hours and that really puts us under pressure," he said.
Despite working two hours over his shift, he said it was difficult to leave.
He said: "Sometimes I feel really bad and that's the worst thing, feeling really bad leaving even though maybe I have stayed after what time I should do.
"But things aren't sustainable and in the future we will have to make sure that people do shifts.
"The traditional way we have staffed most hospitals which is to be a Monday to Friday institution doesn't seem to work and is not fit for purpose anymore."
He said he wanted A&E units like his to be staffed for seven days and to see an expansion in more out-of-hours care.
The government target is for 95% of patients to be seen and treated, admitted or discharged within four hours but on Sunday, 1 September, when BBC Inside Out was at the unit, 17 patients had to wait longer than that.
Earlier this month, Labour MPs criticised the government after it emerged none of the extra £235m for hospital accident and emergency departments this winter had been allocated to the North East.
Health Secretary Jeremy Hunt said it was a sign hospitals in the region were performing "extremely well".
Other steps to tackle growing pressures in A&E include named clinicians for older patients with complex health problems and technology to see patients' GP records.
Sir Bruce's review will look at issues such as seven-day working and an increased role for ambulances in treating and assessing patients.
Previously, Mr Hunt said: "In the long term, I want a 24/7 service which recognises patients as individuals and looks out for them proactively."
Watch more on Inside Out, BBC One at 19:30 BST.