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A record number of people were left waiting at least four hours from the decision to admit to admission in A&E, 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 people had to wait over 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 that 43,792 people waited longer than 12 hours in October, up 34% from 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 risen to a new record high.

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A total of 7.1 million people were waiting to start treatment at the end of September, NHS England said.

This is up from 7.0 million 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 has 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.”

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UK on ‘slippery slope’ to ‘death on demand’, Justice Secretary Shabana Mahmood warns ahead of assisted dying vote

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UK on 'slippery slope' to 'death on demand', Justice Secretary Shabana Mahmood warns ahead of assisted dying vote

The UK is on a “slippery slope towards death on demand”, according to the justice secretary ahead of a historic Commons vote on assisted dying.

In a letter to her constituents, Shabana Mahmood said she was “profoundly concerned” about the legislation.

“Sadly, recent scandals – such as Hillsborough, infected blood and the Post Office Horizon – have reminded us that the state and those acting on its behalf are not always benign,” she wrote.

“I have always held the view that, for this reason, the state should serve a clear role. It should protect and preserve life, not take it away.

“The state should never offer death as a service.”

Analysis: Justice secretary’s intervention is potentially embarrassing for the PM

On 29 November, MPs will be asked to consider whether to legalise assisted dying, through Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill.

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Minister ‘leans’ to assisted dying bill

Details of the legislation were published last week, including confirmation the medicine that will end a patient’s life will need to be self-administered and people must be terminally ill and expected to die within six months.

Ms Mahmood, however, said “predictions about life expectancy are often inaccurate”.

“Doctors can only predict a date of death, with any real certainty, in the final days of life,” she said. “The judgment as to who can and cannot be considered for assisted suicide will therefore be subjective and imprecise.”

Read more: Gordon Brown says assisted dying should not be legalised

Under the Labour MP’s proposals, two independent doctors must confirm a patient is eligible for assisted dying and a High Court judge must give their approval.

The bill will also include punishments of up to 14 years in prison for those who break the law, including coercing someone into ending their own life.

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Details of end of life bill released

Read more: Where does the cabinet stand on assisted dying?

However, Ms Mahmood said she was concerned the legislation could “pressure” some into ending their lives.

“It cannot be overstated what a profound shift in our culture assisted suicide will herald,” she wrote.

“In my view, the greatest risk of all is the pressure the elderly, vulnerable, sick or disabled may place upon themselves.”

Kim Leadbeater waits to present the Assisted Dying Bill. File pic: House of Commons/Reuters
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Kim Leadbeater waits to present the Assisted Dying Bill. File pic: House of Commons/Reuters

Labour MP Kim Leadbeater, who put forward the bill, said some of the points Ms Mahmood raised have been answered “in the the thorough drafting and presentation of the bill”.

“The strict eligibility criteria make it very clear that we are only talking about people who are already dying,” she said.

“That is why the bill is called the ‘Terminally Ill Adults (End of Life) Bill’; its scope cannot be changed and clearly does not include any other group of people.

“The bill would give dying people the autonomy, dignity and choice to shorten their death if they wish.”

In response to concerns Ms Mahmood raised about patients being coerced into choosing assisted death, Ms Leadbeater said she has consulted widely with doctors and judges.

“Those I have spoken to tell me that they are well equipped to ask the right questions to detect coercion and to ascertain a person’s genuine wishes. It is an integral part of their work,” she said.

In an increasingly fractious debate around the topic, multiple Labour MPs have voiced their concerns.

In a letter to ministers on 3 October, the Cabinet Secretary Simon Case confirmed “the Prime Minister has decided to set aside collective responsibility on the merits of this bill” and that the government would “therefore remain neutral on the passage of the Bill and on the matter of assisted dying”.

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‘Immediate action’ taken after blueprints of prisons in England and Wales leaked on dark web

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'Immediate action' taken after blueprints of prisons in England and Wales leaked on dark web

“Immediate action” is being taken after blueprints of jail layouts were shared online.

The maps detailing the layouts of prisons in England and Wales were leaked on the dark web over the past fortnight, according to The Times.

The detailed information is said to include the locations of cameras and sensors, prompting fears they could be used to smuggle drugs or weapons into prisons or help inmates plan escapes.

Security officials are now working to identify the source of the leak and who might benefit from the details.

The Ministry of Justice did not disclose which prisons were involved in the breach.

A government spokesperson said in a statement: “We are not going to comment on the specific detail of security matters of this kind, but we are aware of a breach of data to the prison estate and, like with all potential breaches, have taken immediate action to ensure prisons remain secure.”

The leak comes amid a chronic prison overcrowding crisis, which has led to early release schemes and the re-categorising of the security risks of some offenders to ease capacity pressures.

Justice Secretary Shabana Mahmood is launching a sentencing review in a bid to ease the crisis.

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Starmer says UK will ‘set out a path’ to raise defence spending to 2.5% in spring

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Starmer says UK will 'set out a path' to raise defence spending to 2.5% in spring

The UK will “set out a path” to lift defence spending to 2.5% of national income in the spring, the prime minister has said, finally offering a timeframe for an announcement on the long-awaited hike after mounting criticism.

Sir Keir Starmer gave the date during a phone call with Mark Rutte, the secretary general of NATO, in the wake of threats by Moscow to target UK and US military facilities following a decision by London and Washington to let Ukraine fire their missiles inside Russia.

There was no clarity though on when the 2.5% level will be achieved. The UK says it currently spends around 2.3% of GDP on defence.

Volodymyr Zelenskyy, Nato Secretary General Mark Rutte and  Keir Starmer, during a trilateral meeting in 10 Downing Street.
Pic: PA
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Ukraine leader Volodymyr Zelenskyy, Sir Keir Starmer and NATO boss Mark Rutte in October. Pic: PA

Ukraine war latest: Follow live updates

A spokeswoman for Downing Street said that the two men “began by discussing the situation in Ukraine and reiterated the importance of putting the country in the strongest possible position going into the winter”.

They also talked about the deployment of thousands of North Korean soldiers to fight alongside Russia.

“The prime minister underscored the need for all NATO countries to step up in support of our collective defence and updated on the government’s progress on the strategic defence review,” the spokeswoman said.

“His government would set out the path to 2.5% in the spring.”

The defence review will also be published in the spring.

Read more from Sky News:
Strike using UK-made Storm Shadow missiles ‘very successful’
Putin warns US and UK over ‘escalation of aggressive actions’

While a date for an announcement on 2.5% will be welcomed by the Ministry of Defence, analysts have long warned that such an increase is still well below the amount that is needed to rebuild the armed forces after decades of decline to meet growing global threats from Russia, an increasingly assertive China, North Korea and Iran.

They say the UK needs to be aiming to hit at least 3% – probably higher.

With Donald Trump returning to the White House, there will be significantly more pressure on the UK and other European NATO allies to accelerate increases in defence spending.

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