Accident and emergency departments in England had one of their worst months in July, with record numbers of patients waiting more than 12 hours to be admitted and the lowest proportion of people being seen within four hours.
It was also the joint worst month for response times by ambulances dealing with the most urgent incidents, new figures from NHS England show.
Health leaders said there had been a record number of urgent ambulance call-outs in July, as well as challenges to free up hospital beds due to delays in discharging patients to social care providers.
A record 29,317 people had to wait more than 12 hours in English A&E departments in July from a decision to admit to actually being admitted.
That was up 33% from 22,034 the previous month and the highest for any calendar month in records going back to August 2010.
The number waiting at least four hours from the decision to admit to admission stood at 136,221 in July, up from 130,109 the previous month but slightly below the record 136,298 in March.
A total of 71% of patients in England were seen within four hours of arriving at A&Es last month, down from 72.1% in June – again, the worst performance on record and well below the target operational standard that 95% of patients should be admitted, transferred or discharged within four hours.
That target has not been met nationally since 2015.
Dr Tim Cooksley, president of the Society for Acute Medicine, said it is essential the number of patients waiting for prolonged periods for urgent care does not become the “new normal”.
He said: “Warnings have been issued for many years about the growing crisis across the NHS and in social care and the reality is that we are now at a pivotal moment.
“Patients continue to experience overcrowding in acute care settings with flow throughout the system impaired, and this will have grave consequences as we move through the year.
“We are seeing worse outcomes due to the length of time patients are stuck in emergency departments and acute medical units (AMUs), and paramedics are routinely unable to transfer their patients into hospitals and get back on the road.
“Long-term workforce and capacity plans with short-term mitigations are essential to alleviate the current crisis.”
Separate NHS England figures show the average response time in July for ambulances dealing with the most urgent incidents, defined as calls from people with life-threatening illnesses or injuries, was nine minutes and 35 seconds.
That was up from nine minutes and six seconds in June and the joint longest average response time for that category of incidents since current records began in 2017.
The target standard response time for urgent incidents is seven minutes.
Ambulances in England took an average of 59 minutes and seven seconds last month to respond to emergency calls such as burns, epilepsy and strokes, up from 51 minutes and 38 seconds in June and well above the target of 18 minutes.
It was just short of the longest response time on record for that category of incidents, which is one hour, one minute and five seconds, set in March this year.
Response times for urgent calls, such as late stages of labour, non-severe burns and diabetes, averaged three hours, 17 minutes and six seconds.
That was up from two hours, 53 minutes and 54 seconds in June and just below the record for that category of three hours, 28 minutes and 12 seconds, which was set in March.
During July, which included the heatwave that caused major disruption to travel and fires around the country, staff dealt with more than 85,000 Category 1 ambulance callouts, NHS England said.
That was the highest number since records began and almost two thirds higher than the 51,771 in July 2020, it added.
It said the new figures, published on Thursday, showed the “challenges” faced by staff freeing up beds, and that pressures in areas like social care were impacting on the ability to discharge patients.
On average, there were 12,900 patients a day who spent more time in hospital than needed – an 11% rise on the previous month, NHS England said.
NHS national medical director Professor Sir Stephen Powis said: “Today’s figures show the immense pressure our emergency services are under, with more of the most serious ambulance callouts than the NHS has ever seen before at levels more than a third higher than pre-pandemic.
“Recognising the pressure on urgent and emergency care services, we are working on plans to increase capacity and reduce call times ahead of winter in addition to our new contract with St John to provide extra support as needed.”
Meanwhile, the number of people in England waiting to start routine hospital treatment rose to a new record high, standing at 6.7 million at the end of June.
This was up from 6.6 million in May and was the highest number since records began in August 2007.
Richard Murray, chief executive of The King’s Fund, said that despite the record temperatures, the new figures were more like a health service “stuck in the depths of a particularly dire winter”.
After the new prime minister enters 10 Downing Street next month, winter will soon “really start to bite”, he warned, with Tory leadership hopefuls Liz Truss and Rishi Sunak told that without urgent action, ambulance delays can be expected to worsen – with more people stuck in overcrowded emergency departments.
Mr Murray added: “The intense pressure on NHS and social care services has barely featured in the Conservative party leadership race, yet the new prime minister will inherit a health and care system in a state of steady crisis.
“Ensuring patients can access the care they need will require urgent and sustained action.
“If the next prime minister fails to prioritise action to shore up health and care services, they can expect the NHS and social care to slide even deeper into crisis.”
NHS England data also showed that 430,037 patients, 27.5% of the total, were waiting longer than six weeks for one of 15 key diagnostic tests in June, including an MRI scan, non-obstetric ultrasound or gastroscopy.
The equivalent number in June 2021 was 306,117 (22.4% of the total).
And the stats also showed 229,093 urgent cancer referrals were made by GPs in England in June, down from 242,691 referrals in May.
While that was also down slightly from 230,110 in June 2021, it was still above the 194,047 reported in the non-pandemic month of June 2019.
