Alarm bells over the state of the NHS are ringing again after the latest quarterly report on its performance show “intolerable pressures” and a deeper swing into the red.

According to the data, from NHS Improvement, providers reported a year-to-date deficit of £1.28 billion, £365 million above the target set for this point in the year.

Providers failed in aggregate to achieve the waiting time standard for 14 of the 15 key diagnostic tests, and also missed the 85 percent target for 62 day wait for first treatment following an urgent GP referral, with 82.9 percent recorded.

On a more positive note, 2.3 percent more patients began cancer treatment in the quarter compared to the year ago period, and all other cancer waiting-time standards were achieved in the period.

Also, performance against the four-hour A&E standard was 89.5 percent at the end of December, which, while falling well short of the 95 percent target, is similar to that seen in the period last year (89.6 percent). “This is testament to better operational planning ahead of winter by the NHS and to the hard work of NHS staff,” said NHS Improvement.

However, rising demand for services kept bed occupancy rates high during the quarter, at 88.9 percent, while the number of acute delayed discharge days - further bottlenecking the flow of patients - came in at 303,229. Further adding to the pressure, the NHS currently has 100,000 vacancies to fill.

The figures reflect the “intolerable pressure” on the system, said Niall Dickson, chief executive of the NHS Confederation.

"We have repeatedly pointed to severe underfunding in health and care and a year-to-date deficit in the English NHS of £1,281 million is just the latest evidence of this.

"Our members are at the end of their tether. It is simply not realistic or reasonable to expect the NHS to go on delivering a comprehensive universal service with inexorably rising demand and demonstrably inadequate funding.

“Now time for the political class to wake up and tackle the long-term funding of both health and social care. Nothing less is acceptable.”

Also commenting on the figures, Dr Chaand Nagpaul, BMA council chair, said they paint “an extremely worrying picture”, with performance declining in several key areas.

“It is clear from these figures that the health service just doesn’t have the resource nor capacity to meet rising demand. Without the necessary investment in staff and services the NHS will continue to struggle to meet demand, and current staff will be stretched even more thinly, compounding recruitment and retention problems.

“These figures must act as a wake-up call to the government. The NHS urgently needs greater funding to halt the decline and put the health service on a sustainable footing for the future.”