Data released for August shows that just 61.5 per cent of patients in the Shropshire, Telford & Wrekin Integrated Care Board area were dealt with within the government's four hour target to be admitted, transferred or discharged.
Across the country the average performance was 73 per cent.
It is the second time in four months that the area has been bottom of the table for performance on the target across England.
In May it was the third worst, in June the second worst, and for July and now August it was the poorest performing in the country.
Although the performance is recorded under Shropshire, Telford & Wrekin Integrated Case Board, it tells the story of the under-pressure A&E departments at Royal Shrewsbury Hospital (RSH) and Princess Royal Hospital (PRH) in Telford – both managed by Shrewsbury & Telford Hospital NHS Trust (SaTH).
The figures revealed that across August there were 1,296 patients who waited more than four hours to be admitted, transferred or discharged in the county – out of a total of 4,809.
The data shows that while 1,296 waited more than four hours, another 803 actually waited more than 12 hours from a decision to admit to their admission.
The difficulties experienced at the county's A&E departments have been ongoing for a number of years.
Only this Tuesday health chiefs issued a plea to the public to only attend A&E if they had a 'life threatening injury or illness', warning they were under extreme pressure.
They explained the situation was driven by 'unprecedented' numbers of people attending, with the issue made worse by difficulties faced in discharging medically fit patients.
The ongoing difficulties come against the background of long-running plans to reorganise the operation of both of SaTH's hospitals.
The 'Future Fit' 'hospitals transformation process' will see significant changes in the services offered by the hospitals.
Under the proposals RSH becomes home to the county's only full 24-hour A&E, and also takes on consultant led women and children's services, which move over from PRH.
PRH in turn becomes a centre for planned care, while both hospitals will have urgent treatment centres and Telford also gets an A&E Local.
The proposals are at their most advanced stage yet, with a planning application for the work at RSH currently being considered by Shropshire Council.
Senior medics at SaTH have argued that there must be change in the way the hospitals operate.
Speaking when the application for work at RSH was submitted in July, Dr Ed Rysdale, Consultant in Emergency Care and Clinical Lead for the Hospitals Transformation Programme, said: “Our clinicians agree that we cannot continue as we are.
"Every day we are moving one step closer towards realising our vision to deliver two thriving hospitals and better care for everyone."