A&E waits in England have reached their worst level since the four-hour target was introduced in 2004.
The deterioration in performance came after hospitals appeared to be coping well in the early part of winter. During January, only 84.4% of patients were treated or admitted in four hours - well below the 95% threshold. It means nearly 330,000 patients waited longer than they should with hospitals reporting significant problems finding beds for those needing to be kept in. More than 80,000 patients were kept waiting an extra four hours or more to be transferred to a ward after their wait in A&E.
These are known as trolley waits, since patients are left in temporary waiting areas while a bed is found.
All this comes despite relatively low levels of flu.
The last time the target was met was July 2015.
An NHS England spokesman accepted there were significant pressures, but pointed out that in some respects performance had improved. He said that when performance was combined with December, this winter was actually slightly better than last. There are also more patients coming to A&E than there were last year, which needed to be taken into account, while the mass cancellation of non-emergency treatments that was ordered during last January did not happen this year. There is also a sense that the wider system is working better.
Some patients face delays being discharged form hospital because there is a lack of community care available to support them.
These delays have fallen compared to two winters ago, suggesting council care teams and NHS services are in a better position to provide support to hospitals.
And in the coming years, the budget for the NHS is due to rise by more than 3% compared to the 1-2% it has seen since 2010.
