No one who works in England's Accident and Emergency departments will be surprised by today's figures.

Simon Stevens, the man in charge of NHS England, has described the past financial year as "operationally and financially highly pressurised".

That is management speak for creaking at the seams. Hospital emergency departments have long been seen as the canary in the mine, and right now the canary is struggling to stay on its perch.

Patients haven't had to wait this long for treatment at hospital since 2004, and, for the most seriously ill, it is also taking longer to get there.

Ambulances missed their target to answer three quarters of the most serious 999 calls in eight minutes for the ninth month in a row.

What is going wrong?

When hospitals struggled badly in January, recording the worst figures in over a decade, it was blamed partly on traditional winter pressures - like cold weather and respiratory infections - arriving later than usual.

But NHS performance against key targets has been declining over several years - and just as the government has promised to achieve comprehensive seven-day hospital services.

Many acute trusts are also coping with hefty deficits they need to pay off. In fact, £500 million of the much-vaunted £2bn extra in government funding last year went straight into plugging that gap.

And the most recent indicator of how grim things are came in the past 24 hours.

Lancashire Teaching Hospitals Trust is to downgrade its A&E department at Chorley to urgent care only at night because it has "no other safe options".

The Trust has told ITV News its become impossible to find enough middle-grade doctors to staff its emergency departments properly.

Ambulance services are also struggling Credit: PA

It's not a local problem - there is a nationwide shortage of A&E doctors, one that is now being exacerbated by a pay cap the government has been gradually introducing to curb the amounts hospitals can offer locums.

It's a cost-saving measure designed to try to limit agency bills in the light of those spiralling deficits.

Dr Jennifer Dixon, Chief Executive of the Health Foundation believes all of this was predictable. She says: "The root cause of deteriorating performance is an unprecedented slowdown in funding for the NHS - now half-way through the most austere decade of funding growth since records began in 1948".

The government maintains that it is protecting NHS budgets, despite austerity measures imposed on other departments.

But right now, its clear the cracks are deepening.