Concerns over the ability of the National Heath Service to handle the spike in demand over the winter period are growing after several key targets for A&E admissions, ambulance response times and cancer referrals were missed last month.

According to figures published by NHS England, of nearly 1.9 million attendances at A&E in September, 93.4% were admitted, transferred or discharged within four hours of arrival, failing to meet the 95% standard and slipping from 94.3% in August.

Ambulance response times also failed to meet targets; 72.9% of the most critical calls (Red 1) were responded to within 8 minutes, the fourth month in a row in which the standard of 75% has been missed, while for Red 2 calls, just 68.9% responded within timeframe.

The NHS did meet six of eight cancer targets, but failed to reach the 85% standard for 62 day waiting times, with 81.5% of

patients beginning a first definitive treatment within 62 days from an urgent GP referral for suspected cancer. 

Also, the 93% standard for two-week waiting times for patients with breast symptoms (where cancer was not initially suspected) was not met, with 92.7% of patients being seen by a consultant within 14 days GP referral. 

MP Heidi Alexander, Labour’s shadow health secretary, said the figures “show that the NHS is facing breaking point before winter has even started”, and she warned: “Unless there is an urgent and significant injection of money into the NHS, then standards of care will be compromised this winter”.

Mark Holland, the new president of the Society for Acute Medicine, has also warned that A&E units are facing a “perfect storm” of industrial action from junior doctors, staff shortages and an earlier than expected start to winter pressure.

'Perfect storm'

He told Sky News in an interview that units across the country are already reporting a rise in patients needing emergency care much earlier in the season than normal, and that “there is already talk of putting ambulances on divert, of taking patients to other hospitals”.

NHS England told the media: “Frontline services are treating more patients than ever, and it's right to say that we need strong primary and social care to help offset the pressures on A&E.”

"But it is also worth remembering that, despite the usual flow of negative predictions at this time of year, our services continue to admit or treat and discharge more than nine out of 10 patients within four hours - a higher standard than any major Western nation.”