Alarm bells over the NHS’ ability to cope with looming winter pressures are ringing again after some aspects of service performance sunk to new lows in the summer, with record waiting times for A&E and cancer treatment.

In August, 89.7% of patients were seen at A&E within the 4-hour target, compared to 90.3% in the year-ago period. The 95 percent standard was last met in July 2015.

Also, the number of patients waiting more than 4 hours from decision to admit to admission, grew 5.9% to 39,350, and, of these, 156 patients waited more than 12 hours, rocketing 212% from the figure recorded in August last year.

Elsewhere, at the end of July 2018, there were 4.1 million people on the waiting list for treatment, increasing 7.0% when compared to a year earlier.

With regard to cancer waiting times, 91.9% of people were seen by a specialist within two weeks of an urgent GP referral for suspected cancer in July, falling under the 93% target, while just 78.2% of people received a first definitive treatment for cancer following an urgent GP referral for suspected cancer within 62 days, well below the 85% target.

On the plus side, 97.1% started a first definitive treatment for a new primary cancer, overshooting the 96 percent standard.

Also of note, in July patients spent a total of 140,000 extra days in hospital beds waiting to be discharged, compared to 181,900 in July 2017, marking a drop of 23 percent.

Responding to the figures, a spokesperson for NHS said: “Minor injuries have fuelled a significant rise in A&E visits over the last decade yet against this backdrop, and with pressures increased by the hottest summer on record, hard-working NHS staff saw, treated and discharged or admitted 50,000 more patients within four hours last month than August last year.”

It was also highlighted that NHS waits for operations “are now dramatically shorter, and patients are being seen far quicker - thirty years ago 200,000 people were waiting over a year, now it’s fewer than 5,000.”

However, Dr Taj Hassan, president of the Royal College of Emergency Medicine (RCEM), argued that the data “show that last month was the worst August on record in terms of hospital wide system four-hour performance and shows that despite the best efforts in terms of planning we will be entering autumn and winter in a very fragile state with little room for manoeuvre unless more urgent action is taken with funding for winter”.

“We are also edging closer to being in a position where nearly a third of all patients attending a Type 1 Emergency Department (ED) require admission, meaning that getting more staffed beds is vital. Every hospital Trust must also ensure that they link well to their community & social services to minimise the number who are medically fit but are unable to be discharged.

“For some major EDs to have a 4-hour percentage in the 50-60% range in summer is a major source of risk and these hospitals must ensure that the limited winter pressure funding is committed to ensuring safety,” he warned.

“It is also crucial that these hospital Trusts ensure that they are fully engaged trust wide to take ownership of this target, to improve flow and hence improve conditions for patients and the staff who have to work in such tough conditions in the Emergency Department.”