Emergency care is now in a state of emergency as missed targets reach an all-time high, bed occupancy rates surge, and flu cases increase sharply, and health chiefs warn that patients are “dying in corridors” and the system is “on its knees”.

The four-hour performance target for A&E stood at just 85.1 percent for December, the worst on record, while the figure for major departments was just 77.3 percent. The last time the 95 percent was last achieved was back in July 2015.

Also, in the first week of January, bed occupancy had reached dangerous levels of 95 percent, with around 7,000 less beds open than a year ago.

“Our emergency departments are not just under pressure, but in a state of emergency. This is not just business as usual and these figures make clear the scale of the situation,” warned Dr Taj Hassan, president of the Royal College of Emergency Medicine (RCEM).

“In the last week we’ve seen images of patients laying on floors while they wait to be seen or treated – patients deserve better than this. The frustrations of our overstretched staff are plain to see; with a large group of emergency department clinical leads pushed to the point of writing to the Prime Minister to ask for action. The sentiments and solutions within the letter are echoed by the College.”

NHS Providers has written to health secretary Jeremy Hunt warning of a “watershed moment” for the NHS, and calling on the government to “accept that the service can no longer deliver what is required of it within current funding”.

Despite the NHS preparing more extensively than ever before for this winter, there are not enough beds and staff to ensure care and safety standards for patients.

“Things have deteriorated further from last year and the plan has not worked,” said Dr Hassan, calling for “urgent action” from NHS England and the National Emergency Pressures Panel to address the situation. “We have made recommendations to them that should provide stability and safety in the short term. However, in the medium term, we are going to need investment in staffing, beds and social care to rescue a system that’s on its knees.”

In its letter, NHS Providers, which represents 98 percent of hospital, mental health, community and ambulance service trusts in England, also said it is now “impossible to meet the standards of care set out in the NHS Constitution alongside fully recovering performance targets, consistently maintaining high-quality patient care, investing in the NHS’s capital requirements, and joining up services to deliver 21st century care”.

Urgent decisions on long term funding for health and social care must be taken to allow the NHS to either sustainably deliver all that is required of it under its constitutional standards or change them, it stressed, and noted that regaining the 18-week elective surgery standard alone would cost an estimated minimum of £2-2.5 billion, a calculation that was made before recent decisions to cancel elective operations.

“Looking longer term, three independent health think tanks estimate, based on projections from the Office for Budget Responsibility, that health spending would need to rise to approximately £153 billion (from £123.8 billionn in 2017/18) by 2022/23 to maintain standards of care and meet rising demand. Current Government plans are significantly lower,” the letter highlights.