Welsh trusts were running at full capacity last week as guidance aimed at relieving acute pressures next winter was issued by health secretary Jane Hutt.
Swansea trust chief executive David Williams, who runs 1,300 beds across two acute hospitals, told HSJ: 'Because of emergency pressures I have been postponing and cancelling operations on a regular basis all-year round.
'Seventy-five of our beds are blocked with people who are ready for discharge, but we can't get them a place in a nursing home.'
North East Wales trust has experienced 'severe pressures finding beds' in the past few weeks, chief executive Hilary Pepler said.
'Beds are fully occupied but also we have six unstaffed beds at the moment that we would like to open, but we don't have the staff.
'It is not just money. For a lot of it we know what we have to do, we know we need to set up new ways of working, but it is just heads down around emergency pressures and waiting lists. We don't have the time.'
Swansea has also found it difficult to recruit staff, 'particularly in critical care and operational areas and that has added to pressures', Mr Williams said.
Launching the guidance at Royal Gwent Hospital in Newport, Ms Hutt said: 'I am determined that there should be no repetition of the difficulties faced by the NHS and patients last winter.'
But North Glamorgan trust chief executive Bob Lewis said: 'There's no real let-up for summer. There's really a year-long emergency admissions problem. 'Measures for dealing with it could be built into the routine, he said.
North West Wales trust chief executive Keith Thompson said his trust also experienced pressure in the summer.
The trust has 'an emergency pressures group that meets throughout the year', head of planning and performance review Clare Jones added.
Margaret Foster, chief executive of Pontypridd and Rhondda trust, said discharge arrangements were sometimes easier in summer.
But 'arranging packages of care starting and restarting over Christmas and new year' had 'often been a problem in the past'.
The guidance was produced by the emergency pressures taskforce set up at the beginning of the year.
Key themes include avoiding unnecessary admissions and providing alternative care arrangements, improving internal efficiency - through effective bed management, medical admissions units, fast-track tests and similar measures - and minimising delayed discharges.
A 'keep well this winter' campaign is also promised this year, aimed at over 65s, and will promote flu vaccine uptake, and advise on diet and home heating. Ms Hutt said the taskforce had also been asked to 'provide authoritative advice on how emergency pressures could be better managed on a sustainable basis'.
Emergency Pressures Planning Guidance .
02920-826 807. Free.