There was an increase of 148 patients without a hospital bed at Tipperary University Hospital this October compared to last year.
Over 10,679 people have been without a hospital bed this month according to the Irish Nurses and Midwives Organisation Trolley Watch figures, making it the second highest October on record.
Last year TUH recorded 89 on trolleys, while this year they had 237 over the same period following a high volume of presentations at the Emergency Department in recent weeks.
University Hospital Limerick remains the top of the list locally and the second highest nationally for number of patients on trolleys at 1,268.
While Nenagh saw 10 without a bed last month a decrease of 5 from 2021.
INMO General Secretary Phil Ní Sheaghdha says the sector urgently needs access to private hospital resources, increased staffing and a detailed timeline for the winter plan.