Long A&E waits in England have soared, new figures show, as NHS leaders warned the service was heading into winter under “more pressure than ever”.

Performance against key targets was lower than response times for emergency services and ambulances, Health Service England figures show.

The number of people waiting more than 12 hours in A&E departments in England between an admission decision and actual admission stood at 49,592 in October, up from 38,880 in September.

This is the third highest monthly figure since comparable records began in 2010.

The number of waits of at least four hours after the admission decision also increased, standing at 148,789 in October, compared to 130,632 in September.

Some 73.0% of patients in England were seen within four hours in emergency departments last month, up from 74.2% in September.

Meanwhile, the average response time in October for ambulances in England dealing with the most urgent incidents, defined as calls from people suffering from life-threatening illnesses or injuries, was eight minutes and 38 seconds.

This is an increase from September’s eight minutes and 25 seconds and above the standard response time target of seven minutes.

Ambulances took an average of 42 minutes and 15 seconds last month to respond to emergency calls such as heart attacks, strokes and sepsis.

The goal is 18 minutes.

NHS England said there were 2.36 million visits to A&E last month, 6% more than in October 2023.

Concerns have also been raised that the goal of eliminating all waits of more than 65 weeks for planned care has not been met.

Meanwhile, ambulance crews responded to more incidents than in any other month in October, with more than three quarters of a million (759,019) incidents, including 84,108 Category 1 incidents. more serious.

Rory Deighton, acute director of the NHS Confederation, which represents NHS organisations, said: “These figures show the NHS continues to face record demand, with emergencies and ambulances experiencing their busiest October of all time.

“This comes after the busiest summer and September on record, so it is very concerning that health services are so overheated ahead of what is expected to be another very difficult winter.”

He added: “With record numbers of patients often suffering from multiple or more complex conditions, there is a real risk that services will become overwhelmed and fall into crisis. »

Professor Sir Stephen Powis, national medical director of the NHS, said: “The NHS enters winter under more pressure and busier than ever, with another record month for A&E and ambulance services before it even begins to see a new peak in pressure caused by colder weather and the spread of winter viruses.

“Although we saw 10% more patients in four hours compared to last year, despite record demand, it is essential that people help us by only going to the emergency room or calling 999 if they have any problems. life-threatening emergency, using 111 for other conditions, and getting vaccinated against Covid, flu and RSV if eligible.

The latest monthly performance figures also show:

– The waiting list for routine hospital care in England has fallen to its lowest level in five months – an estimated 7.57 million treatments were waiting at the end of September, affecting 6.34 million patients.

– At the end of September, 22,903 patients were waiting more than 65 weeks to start treatment, compared to 45,527 in August – the target for eliminating all waits more than 65 weeks was September of this year.

– At the end of September, a total of 249,343 people had been waiting in England for more than 52 weeks to start routine hospital treatment. Although the figures are down on those reported at the end of August, health commentators will look at the ambition set by the previous government and NHS England to eliminate all waits of more than a year by March 2025.

– In cancer care, some 74.8% of English patients referred urgently for suspected cancer in September were diagnosed or had their cancer ruled out within 28 days, below the target of 75 %.

– And the proportion of patients in England who had waited no more than 62 days in September between an urgent referral for suspected cancer or a consultant upgrade to their first definitive cancer treatment was 67.3 %, compared to 69.2% in August. The target is 85%.

Professor Peter Friend, vice-president of the Royal College of Surgeons of England, said: “Staff are working tirelessly to ensure the NHS can once again provide timely care. However, with the 65 week target missed and a very difficult winter ahead, progress will be slow.

“This means more people are suffering and unable to work and, in some cases, needing emergency care, putting even more pressure on the NHS.”

Health experts have warned that NHS performance problems are “endemic” across the country.

It comes after Health Secretary Wes Streeting said failing hospitals would be named and shamed in league tables and NHS managers would be sacked if they failed to improve patient care and take the lead. financial control.

Commenting on the latest performance figures, Siva Anandaciva, chief analyst at The King’s Fund, said: “The figures show that NHS performance problems are endemic across the country and deep-rooted, with many key targets failing to meet been affected for years.

“Only 73% of people are seen within four hours in the emergency department, compared to the NHS standard of 95% – a target not met for more than eight years – and a target missed by every hospital trust running a major emergency department. emergencies in England.

“People are waiting 42 minutes for an ambulance for urgent cases such as strokes when the target is 18 minutes – a target which has not been met for more than four years.

“Ministers rightly want to improve the poor quality of care many patients receive. Transparency is a good goal, but rankings alone will not lead to better, faster care this winter and could have the unintended consequence of health leaders focusing too much on bottom-up reporting to national agencies, instead instead of focusing on the needs of their local communities. »

Dr Vicky Price, President-elect of the Society for Acute Medicine, added: “This data shows that there is a desperate need for the Government to turn its attention to the threat of winter and the action it must take to reduce the impact of winter. inevitable crisis that we will face in hospitals over the coming months.

“We are very concerned that the focus is on the wrong areas, with talk of introducing rankings, penalties and consultations distracting from the urgent need to deliver meaningful solutions on the ground right away. NOW.

At the same time, health officials have also issued a warning about a rise in superbugs in England.

The UK Health Security Agency said there would have been around 66,730 serious antibiotic-resistant infections in 2023, up from 62,314 in 2019.

People who get a bacterial infection resistant to one or more antibiotics are more likely to die within 30 days than those who respond to treatment.

Professor Dame Jenny Harries, chief executive of the UKHSA, said: “Increasingly, the first antibiotics patients receive are not effective in fighting their infections. This isn’t just an inconvenience: it means they’re at greater risk of developing serious infection and sepsis.