More people than ever are on the waiting list for NHS treatment and not a single A&E department hit the four-hour target for seeing patients, new figures have shown.
Data from NHS England shows just 81.4% of A&E patients were seen within four hours in November – the worst figure on record and set against a target of 95%.
There were 88,923 patients waiting more than four hours from a decision to admit to hospital admission, 64% higher than the same month last year when it was 54,373.
Of these, 1,112 patients waited more than 12 hours compared with 258 in November 2018, a 331% rise.
The number of people waiting for treatment, such as knee and hip replacements, was also at its highest-ever level – 4.45 million – in October.
Just 84.7% of patients are starting treatment within 18 weeks against a target of 92%.
Targets on how long people should wait for cancer treatment also continue to be missed, the data shows.
NHS weekly figures show there were 28 occasions on which A&Es were forced to divert ambulances to other hospitals due to being overwhelmed.
Thousands of patients have also been stuck in ambulances outside hospitals due to delays in handing them over to A&E.
NHS medical director Professor Stephen Powis said that despite planning and hard work, “there’s no doubt that a combination of increasing demand and workforce pressures are going to make for a very tough few months for NHS teams”.
Nuffield Trust chief executive Nigel Edwards said: “Returning to Downing Street, Boris Johnson has been met by an immediate reminder of the grim winter his Government faces in the English NHS.
“The November figures show the number of patients waiting on trolleys is at its highest level ever, a very worrying sign with the coldest months still to come.
“For the first time, not one single major A&E department in England met the current four-hour waiting time target.
“Figures for the first week of December suggest what may be driving this, showing bed occupancy at 95%, a level which will make it near impossible to admit many patients in need on to the right ward.
“To tackle this, the new government really will need to deliver the 50,000 nurses promised – even if this means more reliance on migrants than they’ve said.”
Dr Rebecca Fisher, a GP and senior policy fellow at the Health Foundation, said: “Without more money and more staff, it will be challenging for the NHS to reverse the current deterioration.
“Our analysis shows that the NHS will need an increase of £20 billion by 2023-24 just to maintain standards of care but more will be needed to improve services.
“The £18 billion extra promised by the Conservatives during the election campaign falls short of what is needed.”
An NHS spokesman said: “These figures show that NHS teams across the country are providing a record-breaking level of care to the increasing numbers of people, at a time when norovirus and flu is having a greater impact on local services than last year.”
Dr Katherine Henderson, president of the Royal College of Emergency Medicine, said: “Performance continues to plummet to record lows despite the best efforts of staff.
“Our hospitals are near full and the number of patients needing to be admitted to a bed continues to rise year on year.
“Thousands of patients are staying longer than 12 hours in emergency departments each week.
“Patients are suffering as a result of years of under-resourcing. We welcome the promises made on health spending by the new government.
“For the sake of our patients, these promises must be turned into actions, and now is the time to act.”
Niall Dickson, chief executive of the NHS Confederation, said: “These figures show an NHS on its knees and it is no wonder that most leaders predict that this winter will be the worst on record.
“More and more patients are turning up at emergency departments and there is a limit as to how many they can cope with.
“Frontline staff are working themselves into the ground but with the current level of vacancies, and ever rising demand, there is only so much they can do.
“We need our newly elected government to get to work now with new services in the community that will relieve the pressure on hospitals, as well as action on staffing, social care and capital investment.”
Richard Murray, chief executive of The King’s Fund, said: “National waiting time standards enshrined in the NHS Constitution have now been routinely missed for several years.
“Hospitals are constantly operating in the red zone, with NHS trusts struggling to cope with more than 100,000 (staff) vacancies.”