A record number of people were left waiting at least four hours to be admitted to hospital A&E departments, NHS England figures show.
The number waiting reached a peak of 150,922 in October, up from 131,861 the previous month.
More than 30% of patients had to wait more four hours to be seen in A&E in October, including 45% of people attending Major A&Es (excluding minor injuries units and specialist centres).
The operational standard is that at least 95% of patients attending A&E should be admitted, transferred or discharged within four hours, but this has not been met nationally since 2015.
The number of people waiting more than 12 hours in A&E departments in England from a decision to admit to actually being admitted has also risen to a new record high.
New NHS England data shows 43,792 people waited longer than 12 hours in October, up 34% on 32,776 in September and the highest number in records going back to August 2010.
It comes as the number of people in England waiting to start routine hospital treatment has also risen to a new record high.
A total of 7m people were waiting to start treatment at the end of September, NHS England said.
This is up from 7m in August and is the highest number since records began in August 2007.
Meanwhile, 401,537 people have been waiting longer than a year to start hospital treatment, up from 387,257 at the end of August and equivalent to around one in 18 people on the entire waiting list.
Very long waits of more than two years have fallen slightly, while the number of people waiting 18 months for treatment has dropped by almost 60% in one year, NHS England said.
The rate cancer patients in England saw a specialist within two weeks of seeing their GP has also slumped to an all-time low.
Data shows 251,977 urgent cancer referrals were made by GPs in September, but only 72.6% were seen within the two-week timeframe.
It also showed that nearly 6,000 cancer referral patients waited more than two months to be seen by a specialist.
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Ambulance waiting times were also a long way outside their targets, with the average response time to people with life-threatening injuries outside London clocking in at nine minutes 56 seconds – almost three minutes over the target time of seven minutes.
Figures also revealed the number of people in England waiting longer than six weeks for a key diagnostic test had risen to the highest level in two years.
Some 463,930 patients – 29.8% of the total – had been waiting longer than six weeks for one of 15 standard tests in September, including MRI scans, non-obstetric ultrasound or gastroscopies.
This is up from 461,400 the previous month and the highest number since August 2020, when 472,517 patients had been waiting longer than six weeks.
Analysis
The figures are stark. There is no other way to say it.
Even gains made in previous months are reversing or slowing down.
And the worrying thing is as it gets busier we are still nowhere near peak winter.
Covid, flu and A&E attendances are driving the pressure according to the NHS.
They say last month was exceptionally busy and that is reflected in the record waiting times right across the board from ambulance attendances, A&E waiting times and trolley waits.
There are more people going into hospital than leaving. The lack of social care provision is why.
So as winter really starts to bite that pressure and those waiting times are only going to rise to more record highs.
Add to the mix the impending nurses strike. We don’t know when or how many days but any operations, procedures and appointments that have to be cancelled will have to be rescheduled.
And that, again, means lists grow. And it is not just nurses who are taking industrial action.
The unions for non-clinical staff who work in hospitals, the army of people that make these buildings work, are balloting their members too.
NHS medical director Professor Sir Stephen Powis said: “There is no doubt October has been a challenging month for staff, who are now facing a tripledemic of COVID, flu and record pressure on emergency services with more people attending A&E or requiring the most urgent ambulance callout than any other October.
“Pressure on emergency services remains high as a result of more than 13,000 beds taken up each day by people who no longer need to be in hospital.
“But staff have kept their foot on the accelerator to get the backlog down, with 18-month waiters down by three-fifths on last year.
“We have always said the overall waiting list would rise as more patients come forward, and, with pressures on staff set to increase over the winter months, the NHS has a plan – including a new falls service, 24/7 war rooms, and extra beds and call handlers.”
