The NHS is going into winter “in bad shape”, experts have warned, as new figures show key targets continue to be missed amid rising waits.
Figures from NHS England show the waiting list for routine hospital treatment in England has climbed to its highest level for 10 months.
An estimated 7.64 million treatments were waiting to be carried out at the end of August, relating to 6.42 million patients – up from 7.62 million treatments and 6.39 million patients at the end of July.
These are the highest figures since October 2023.
It comes as some GPs take part in collective action to limit the number of patients they will see to 25 per day and are refusing to bow to any local pressures to “ration” referrals, investigations and admissions, according to guidance from the British Medical Association (BMA).
Siva Anandaciva, chief analyst at the King’s Fund charity, said: “The NHS is approaching winter in bad shape.
“Industrial action is continuing, financial pressures are rising, and important performance targets continue to be missed.
“Despite the hard work of staff, patient care in the NHS continues to fall short of expectations.
“Today’s statistics show it has been three years since A&E performance was above the current temporary target of 78% of people waiting under four hours and nearly a decade since the official target of 95% of people being seen in four hours was met.
“It has been four years since the 18-minute target for the average ambulance response time to conditions such as strokes and heart attacks was met.
‘The Government has made its diagnosis that the NHS is broken, and now they must fix it.”
Mr Anandaciva pointed to suggestions the NHS will be put at the centre of the upcoming Autumn Budget on October 30, but said “the proof will be in the pudding of how far the Government are willing to go”.
He added: “While sticking plasters are not the solution to the crises facing the NHS, without an injection of more resources to get through the next few months and seeds of hope for the coming year, NHS services will have to make harsh trade-offs between immediate winter preparations and longer-term improvement.”
Tim Gardner, assistant director of policy at the Health Foundation, said: “We estimate an additional £38 billion is needed to significantly improve the NHS and tackle long waits by the end of this Parliament (2029/30).
“The upcoming Budget is a crucial opportunity for the Government to start showing how it intends to turn its ambitions into reality.”
Thursday’s data showed 3,335 patients in England had been waiting more than 18 months to start routine treatment at the end of August, up from 2,738 in July.
The previous government and NHS England set the ambition of eliminating all waits of more than 18 months by April 2023, excluding exceptionally complex cases or patients who choose to wait longer.
The figures also showed 45,527 patients had been waiting more than 65 weeks to start treatment at the end of August, down from 50,860 in July.
The revised target to eliminate all waits of more than 65 weeks is September 2024.
The data also showed that the number of people waiting more than 12 hours in A&E departments from a decision to admit to actually being admitted stood at 38,880 in September, up from 28,494 in August.
The number waiting at least four hours from the decision to admit to admission also rose, standing at 130,632 in September, up from 116,489 in August.
The Royal College of Surgeons of England warned it will be difficult for the revised September 65-week target to be met.
Its vice president Professor Frank Smith said: “With waits of over 65 weeks still standing at 45,527 in August, the promise to eliminate these waits by September looks very hard to achieve.
“Too many patients continue to have to live in pain and anxiety, potentially unable to get back to work and help grow our economy.
“If the new Government wants to show it is serious about meeting its pledge to cut waiting times, it must provide capital funding for NHS buildings and IT in the Autumn Budget later this month.
“With reports of broken lifts and flooded corridors in hospitals leading to cancelled operations, and surgeons telling us access to operating theatres remains an issue, cutting waits will remain an uphill battle without this investment.”
Dr Tim Cooksley, immediate past president of the Society for Acute Medicine, said the A&E 12-hour waits were “up more than 20% on last year at 38,880 patients”.
He added: “This is a dire situation for the patients who are left receiving degrading corridor care and for staff who are stretched to their limits and are having to provide care in inappropriate environments.”
NHS England said staff in A&E experienced their busiest ever September with 2.21 million attendances, and 530,824 emergency admissions.
It added that the NHS has delivered 11.96 million treatments so far this year – 570,263 or 5% more than the same year pre-pandemic (11.39 million in the year to August 2019).
Professor Sir Stephen Powis, NHS national medical director, said: “These latest figures show the pressure we saw over summer is not letting up with too many patients waiting too long for treatment, following a record September for A&E attendances and 1.2 million more attendances so far this year than before the pandemic.
“We know this is likely to be another incredibly busy winter, with extra demand and the threat of a ‘tripledemic’ of Covid, flu and RSV, and last month we set out our winter plan which included better data reporting and more care in the community like falls services and virtual wards, so we can see patients as quickly as possible in the busy months ahead.
“As pressure builds and the risk of Covid, flu and RSV starts to rise I’d again encourage anyone eligible for vaccinations to come forward as soon as possible to avoid you or your loved ones getting seriously ill, as well as calling 999 in an emergency and using 111 online for any other conditions.”
Health minister Karin Smyth said: “This Government is working at pace to radically reform the NHS through the 10-Year Health Plan, focusing on three big shifts from analogue to digital, sickness to prevention and hospital to community, so the NHS can be there for us when we need it, once again.”
Separate figures from NHS England show 6.6% of people in England (around one in 15) were known to be in contact with secondary mental health, learning disabilities and autism services during 2023/24. This compares to 6.3% of people in 2022/23 and 5.8% of people in 2021/22 (around one in 17).
This includes children and adults.