Usually May and June provide a breathing space for hospital staff - but figures show that is not the case this year.
ITV News reveals the number of people being dealt with at A&E within four hours has deteriorated after an unexpected rise in demand.
NHS staff involved in Sam Morrish's death met at a press conference this morning to apologise unreservedly for their failings.
The Government has defended its funding of GP services, saying two-thirds of the NHS budget is controlled by local family doctors and finding extra cash will "mean reductions elsewhere".
An NHS England spokeswoman said:
– An NHS England spokeswoman
Two thirds of the NHS budget is now controlled by local GPs and like them we want to see more investment in primary care, including modern buildings.
While the NHS budget has been protected, which is welcome, finding more money in one area will inevitably mean reductions elsewhere.
Some 39% of GPs feel the premises they see patients on is in too poor shape to properly care for them.
According to a poll of 4,000 GPs:
- Two thirds said they had been prevented from developing or refurbishing their premises because of a lack of cash.
- And a number raised concerns about the impact of "hot-desking", or sharing consulting rooms with colleagues, saying that it hampered their ability to carry out a full range of services.
Patients are not getting the care they need as many GP surgeries are "unfit for purpose", according to the British Medical Association (BMA).
Crumbling surgery buildings are preventing patients getting access to the services they need "undermining" care, the union said.
One of Britain's top GPs, Dr Chaand Nagpaul, warned many surgeries had seen "no real investment" over the last 10 years.
Dr Nagpaul, chair of the BMA's general practitioners committee, said: "Far too many practices have seen no real investment in their buildings in the past ten years, leaving them in cramped, unsuitable conditions that are hindering the ability of many to even offer basic general practice services.
"Practices also reported being prevented from relocating to more suitable premises because of a lack of resources."
Just seven of Monitor's 337 staff have a background in medicine and only 21 have had experience working in the health service.
– PAC chairwoman Margaret Hodge
These are tough times for the NHS. The number of NHS foundation trusts in difficulty is growing, and this casts doubt on Monitor's effectiveness as their regulator.
Over a quarter of foundation trusts, 39 out of 147, were predicted to be in deficit at the end of 2013-14, evidence of the increasing financial challenges they are facing.
These trusts are suffering from serious financial pressures, poor leadership or both, and some have been allowed to go on struggling for more than four years.
The MPs made a string of recommendations for the regulator.
They said that it must take faster action in trusts where problems have been identified. Some with difficulties in leadership or finances have been allowed to struggle on for "too long", they added.
An influential group of MPs has called into question the effectiveness of Health regulator Monitor. The regulator "must get better" at identifying NHS hospital trusts at risk of failure, the Public Accounts Committee (PAC) said.
Its latest report highlighted the large proportion of foundation trusts, which Monitor regulates, that are in financial difficulties. Around a quarter of foundation trusts predicted that they would end the 2013/14 financial year in deficit, the report states.
The MPs also said that Monitor's credibility is "damaged" by a lack of experience in the NHS among staff.
A survey of GP patients in England suggests they are less satisfied in the service provided than they were two years ago.
Of the 903,357 adults questioned in the Ipsos Mori survey for NHS England:
- 34% have a "very good" experience of making an appointment compared with 38% in June 2012
- 36% were "very satisfied" with their surgery's opening hours, down from 40% in June 2012
- 86% were successfully able to get appointment to see or speak to someone at their surgery
- 34% would prefer to book their appointments online compared with 29% in June 2012
- 78% would recommend their GP surgery to someone who moved to the local area, which is down from 82% in June 2012
More than a quarter of visits made to accident and emergency departments in England are made by people who cannot get an appointment with their GP, research has found.
A study by Imperial College London revealed that almost 5.8 million trips to A&E stemmed from patients who had unsuccessfully tried to meet with their family doctor.
Around 58% of patients questioned at an emergency department in a London hospital admitted they were there because it was "quicker than getting a GP appointment".
A large majority of those patients' ailments could have been managed by a GP or emergency nurse practitioner, the research said.
Government funds allocated to GP services have increased by a third over the last 11 years, according to a top NHS official.
Ben Dyson, director of commissioning policy and primary care at NHS England, disputed claims GP services were underfunded and overstretched:
– Ben Dyson
Since 2002/03, the money that the NHS spends on GP services has increased by a third and patient consultations have been increasing year-on-year, but patients should not be unable to get appointments.
A major programme of work to help transform GP services, including patient access, has begun, including the Prime Minister's £50 million Challenge Fund that will support GPs in improving access to services, in more modern ways with greater use of telephone, email and video consultations as well as more flexible appointment times.
GPs are "heaving under the strain of rocketing patient demand" as the NHS tries to care for an ageing and growing population, despite funding cuts.
Dr Maureen Baker, chairwoman of the Royal College of GPs, said:
– Dr Maureen Baker
Every patient should be able to see their family doctor when they need to, and GPs want to provide the best possible access and high-quality care for all their patients.
But this research is further evidence of the crisis in general practice, with family doctors heaving under the strain of rocketing patient demand, due to a growing and ageing population, and plummeting investment.
More than 90% of patient contacts in the NHS are dealt with in general practice - for only 8.39% of the budget.
Accident and Emergency (A&E) wards are struggling to cope with additional patients who were unable to get an appointment with their GP, it has emerged.
A report published in the British Journal of General Practice found nearly six million patients had chosen to go to an English A&E department because they could not get a convenient appointment with their GP.
For every 100 patients who try to get an appointment at their local GP surgery, 1.7 will resort to attending the emergency department, the report authors said.
Experts from Imperial College London analysed the results from the national GP Patient Survey from 2012/13, which is answered by around one million patients, and the annual numbers of GP consultations.
Research suggested 1.67% of patients wound up at A&E because they struggled to get a GP appointment.