Waits at A&E departments in England have hit their worst levels since records began, official NHS statistics have shown.

Despite pressures from flu and bad weather so far this winter being significantly lower than in 2018, performance against the flagship four hour target in January hit its lowest level since its introduction in 2004.

NHS leaders said Thursday’s figures must be a wakeup call to the government that chronic underfunding in social care and a mounting staffing crisis is creating dangers for patients.

While more patients than ever are being seen at A&E departments, just 84.4 per cent were seen, admitted or sent home within four hours of arrival – well below the target of 95 per cent.

This is worse than the 84.6 per cent mark set in in March 2018 after the Beast from the East storm – the previous lowest figures on record.

Everyone the Government blames for the NHS crisis – except themselves Show all 6 1 /6 Everyone the Government blames for the NHS crisis – except themselves Everyone the Government blames for the NHS crisis – except themselves The elderly “We acknowledge that there are pressures on the health service, there are always extra pressures on the NHS in the winter, but we have the added pressures of the ageing population and the growing complex needs of the population,” Theresa May has said. Waits of over 12 hours in A&E among elderly people have more than doubled in two years, according to figures from NHS Digital. Getty Everyone the Government blames for the NHS crisis – except themselves Patients going to A&E instead of seeing their GPs Jeremy Hunt has called for a “honest discussion with the public about the purpose of A&E departments”, saying that around a third of A&E patients were in hospital unnecessarily. Mr Hunt told Radio 4’s Today programme the NHS now had more doctors, nurses and funding than ever, but explained what he called “very serious problems at some hospitals” by suggesting pressures were increasing in part because people are going to A&Es when they should not. He urged patients to visit their GP for non-emergency illnesses, outlined plans to release time for family doctors to support urgent care work, and said the NHS will soon be able to deliver seven-day access to a GP from 8am to 8pm. But doctors struggling amid a GP recruitment crisis said Mr Hunt’s plans were unrealistic and demanded the Government commit to investing in all areas of the overstretched health service. Getty Everyone the Government blames for the NHS crisis – except themselves Simon Stevens, head of NHS England Reports that “key members” of Ms May’s team used internal meetings to accuse Simon Stevens, head of NHS England, of being unenthusiastic and unresponsive have been rejected by Downing Street. Mr Stevens had allegedly rejected claims made by Ms May that the NHS had been given more funding than required. Getty Everyone the Government blames for the NHS crisis – except themselves Previous health policy, not funding In an interview with Sky News’s Sophy Ridge, Ms May acknowledged the NHS faced pressures but said it was a problem that had been “ducked by government over the years”. She refuted the claim that hospitals were tackling a “humanitarian crisis” and said health funding was at record levels. “We asked the NHS a while back to set out what it needed over the next five years in terms of its plan for the future and the funding that it would need,” said the Prime Minister. “They did that, we gave them that funding, in fact we gave them more funding than they required… Funding is now at record levels for the NHS, more money has been going in.” But doctors accused Ms May of being “in denial” about how the lack of additional funding provided for health and social care were behind a spiralling crisis in NHS hospitals. Getty Images Everyone the Government blames for the NHS crisis – except themselves Target to treat all A&E patients within four hours Mr Hunt was accused of watering down the flagship target to treat all A&E patients within four hours. The Health Secretary told MPs the promise – introduced by Tony Blair’s government in 2000 – should only be for “those who actually need it”. Amid jeers in the Commons, Mr Hunt said only four other countries pledged to treat all patients within a similar timeframe and all had “less stringent” rules. But Ms May has now said the Government will stand by the four-hour target for A&E, which says 95 per cent of patients must be dealt with within that time frame. Getty Images Everyone the Government blames for the NHS crisis – except themselves No one Mr Hunt was accused of “hiding” from the public eye following news of the Red Cross’s comments and didn’t make an official statement for two days. He was also filmed refusing to answer questions from journalists who pursued him down the street yesterday to ask whether he planned to scrap the four-hour A&E waiting time target. Sky News reporter Beth Rigby pressed the Health Secretary on his position on the matter, saying “the public will want to know, Mr Hunt”. “Sorry Beth, I’ve answered questions about this already,” replied Mr Hunt. “But you didn’t answer questions on this. You said it was over-interpreted in the House of Commons and you didn’t want to water it down. Is that what you’re saying?” said Ms Rigby. “It’s very difficult, because how are we going to explain to the public what your intention is, when you change your position and then won’t answer the question, Mr Hunt”. But the Health Secretary maintained his silence until he reached his car and got in. Getty

While more than half a million patients were admitted to hospital from A&E last month, more than 80,000 waited over four hours for a bed to be found, and 600 patients had to wait over 12 hours.

“It’s a sad indictment of the state that our health service has been allowed to fall into that thousands of patients needing urgent medical help face the awful prospect of being left stranded in cramped corridors or on hospital trollies waiting for a hospital bed to become available,” Rachel Power, chief executive of the Patients Association, said.

Waits were even worse at major emergency departments, the 24-hour units in hospitals known as type one A&Es. Although the national four hour target also considers smaller minor injury units and walk-in centres, at type one units across England just 76.1 per cent of patients were seen within four hours.

The Royal College of Emergency Medicine (RCEM) said the pressures had been normalised by years of cuts to beds and staff, and A&Es are now in “chronic crisis”.

“These figures make clear the true scale of this crisis facing our systems,” RCEM president Dr Taj Hassan said.

“Despite a relatively mild winter, with lower rates of norovirus, nearly one in four people are waiting over four hours, and nearly a third of all attendances require admission; the need for more beds could not be clearer.”

These pressures create crowding and add to the risk of harm to patients, as well as deaths and disability, he added.

Last year The Independent revealed how a record heatwave and sustained funding squeeze had sapped the ability of hospitals to recover over summer.

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Despite milder conditions, pressure this winter is coming from the inexorable rise in patient numbers, with more than 2.11 million attendances in January – an increase of 85,000 on 2018.

This is being driven by the increasing elderly population, but also stems from a decade-long funding squeeze which means accessing social care services, GPs and other preventative services has been made harder.

While A&E is the most visible sign of stress, the statistics released on Thursday show performance is suffering in other areas too.

More than 164,000 patients waited over two weeks to see a consultant after being urgently referred by their GP because of suspected cancer in 2018, a 50 per cent rise on 2017, end of year data also released on Thursday shows. Around 4,600 patients waited more than the target of two months to start treatment after a referral, which was a 17 per cent increase.

Macmillan Cancer Support said this is creating “anxiety and even depression” for patients.

‘I understand the cuts but I feel let down,’ says Hannah who was eventually diagnosed with lymphoma (Hannah / Macmillan)

Hannah, 21, from Bradford was referred by her GP with suspected lymphoma in July, and should have seen a consultant within two weeks. In the end it took until November to get diagnosed, after she had chased her own referral, and she only began chemotherapy in December.

“I understand the cuts are having a big effect, but at the end of the day it’s people’s lives,” Hannah told The Independent.

“I feel let down and really quite disappointed. I understand the NHS is free but you can only be so grateful when you’ve been through a year like I’ve been through.”

The waiting list for NHS operations hit its highest level since 2007 last year, and the figures show just 86.6 per cent of patients started treatment within 18 weeks, against a target of 92 per cent.

Despite pressure to cut waits, there were 70,000 fewer consultant-led treatments last year than in 2017, and 200,000 fewer than in 2014, which the Royal College of Surgeons blamed on bed shortages and cancellations.

The recently published NHS 10-year plan sets out how new funding, in place from April, will be used to improve services, but does not address social care, staffing shortages and the future of NHS waiting time targets.

The Royal College of Nursing (RCN) said the figures were a wakeup call. “Speak to anybody at the coalface and they will tell you that it’s patients who are paying the price for the lack of staff and overcrowding at A&Es,” Patricia Marquis, RCN England director said.