Ambulance response targets have been missed for the 14th month in a row, new figures from NHS England show.
Statistics for July show 67.6% of top priority calls were responded to within eight minutes, below the 75% target.
The response target to "Red 2" calls - life threatening emergencies other than a person in cardiac arrest or who has stopped breathing - was also missed, with the standard not being met since January 2014.
Figures for A&E attendances showed 90.3% of patients were dealt with within the four hour target, below the 95% standard.
There were more than two million attendances at A&E in July 2016, 6.3% higher than in July 2015.
Emergency emissions were also up, with 490,221 in July.
The figures also reveal there was the highest number of delayed transfer of care since monthly data was first collected in August 2010, with 184,188 delayed days in July.
The NHS England data also showed a steep rise in the number of people dialling 111 for non-emergency care.
There were 1,238,972 calls to the service in England in July 2016, up 21.9% on July last year.
You can read the full summary of performance statistics by clicking here.