ITV News Health Editor Emily Morgan reports on the strains weighing on the health service which has left some patients waiting 20 hours for a bed
Ambulance response times are longer than ever, more people are waiting longer to be seen in A&E, and the number of patients waiting for hospital treatments has reached a record high.
The findings come as figures for ambulance response times, A&E wait times and routine hospital treatment waiting lists have been released by the NHS.
The key stats are as follows:
Ambulance response times are the longest in October since current records began in August 2017 - with the average response time for the second most serious category (53 minutes and 54 seconds) three times the target average of 18 minutes.
For A&E services, some 121,000 people waited at least four hours and 7,059 people had to wait more than 12 hours - the highest monthly tolls since records began in August 2010.
Patients waiting to start routine hospital treatment at the end of September 2021 reached a record of 5.8 million - the highest number since NHS England records began in August 2007.
Waiting nearly an hour for an ambulance
Paramedics say patients are "at risk" as NHS England data show response times in October are the longest since current records began in August 2017.
For the most serious category - Category 1, which signals an immediate response to a life threatening condition, such as cardiac or respiratory arrest - the average response time was nine minutes and 20 seconds.
It missed the standard of an average of seven minutes.
For Category 2 calls - which indicates a serious condition, such as stroke or chest pain, which may require rapid assessment or urgent transport - the response time was 53 minutes and 54 seconds.
This is more than double the target average of 18 minutes.
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Response times for urgents calls (Category 3) – which includes late stages of labour, non-severe burns and diabetes – averaged three hours, nine minutes and 58 seconds.
Richard Webber, of the College of Paramedics and a working paramedic, told the BBC his colleagues “have never before experienced anything like this at this time of the year”.
He said: “Every day services are holding hundreds of 999 calls with no one to send.
“The ambulance service is simply not providing the levels of service they should – patients are waiting too long and that is putting them at risk.”
Outside of England, the Scottish Police Federation have also indicated problems as officers have driven patients to hospital. In Wales, the military was brought in to ease the strain on the emergency services.
Ambulance leaders said there was the “highest level of emergency activity in history” in October and raised concerns about the time lost to hospital handover delays.
Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said the hours lost due to delays in waits of more than 60 minutes rose more than six-fold in six months, from 4,700 in April to 35,000 in September.
Speaking in October, he said: “These delays are in part due to the need to maintain social distancing in EDs alongside the unprecedented pressures in the whole urgent and emergency care system at present."
Tens of thousands waiting at least four hours in A&E
Record numbers of patients have had to wait at least four hours to be seen at Accident and Emergency (A&E) departments in England.
In October, some 121,000 people waited at least four hours and 7,059 people had to wait more than 12 hours, up from 5,025 in September.
The numbers are the highest monthly tolls since records began in August 2010.
A&E attendances in October 2021 reached pre-pandemic levels of 2.2 million, a 36% rise from 1.6 million in the same month last year.
The rise could be attributed to lower-than-usual numbers for October 2020, which were affected by the Covid-19 pandemic.
Record high hospital treatment waiting list
Another record has been broken as 5.8 million people were waiting to start routine hospital treatment at the end of September 2021.
This is the highest number since NHS England records began in August 2007.
Out of those, 300,566 patients had been waiting more than 52 weeks, up from 292,138 in August and more than double the number waiting a year earlier.
And 12,491 people were waiting more than two years, up from 9,754 at the end of August.
NHS England has told hospitals to eliminate all waits of more than two years by March 2022.
The total number of people admitted for routine treatment in hospitals in England in September 2021 was 252,699 – up 21% from a year earlier. Although, in September 2020, figures were lower than usual due to the pandemic.
Before the pandemic in September 2019, 288,230 were admitted for routine hospital treatment.
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Waiting lists for diagnostic tests and cancer referrals
NHS England figures also show 369,207 patients had been waiting more than six weeks for a key diagnostic test in September - including an MRI scan, non-obstetric ultrasound or gastroscopy.
In September 2020, the number was 419,841. Before the pandemic in September 2019, there were 38,802.
And urgent cancer referrals made by GPs reached 231,421 in September, up 15% from the 201,013 in the same month last year.
Before the pandemic in September 2019, the number was 195,196.
Urgent referrals where breast cancer symptoms were present rose from 11,122 in September last year to 12,088 in September 2021.
A poll for the NHS Confederation - a body representing all organisations providing NHS services - found leaders in England said the health service has reached “tipping point”, with nearly nine in 10 (88%) saying the demands on their organisation are unsustainable.
About 87% said staff shortages are putting patient safety and care at risk.
The survey of 451 leaders included those from hospitals, ambulance services, mental health providers, community services and primary care.