Leading accident and emergency doctors have warned of a winter crisis in the National Health Service as official data shows a 43% rise in the numbers waiting more than four hours in A&E departments compared with two years ago.
The NHS figures also reveal an 89% leap in the number of "trolley waits" of four to 12 hours when data for September is compared with September 2011.
Describing the NHS England figures as "a cause for grave concern", the leader of Britain's A&E doctors, Cliff Mann, said this winter was shaping up to be the toughest the NHS had ever faced. "All the worrying indicators are up already. And they seem to indicate that this winter will probably be worse than last winter, which was the worst we have ever had, a tipping point for the NHS's delivery of acute care."
Mann, who is president of the College of Emergency Medicine (CEM), which represents A&E doctors, added: "It's not chaos in emergency departments, but it is a crisis. Colleagues at hospitals report that there are almost daily instances in most A&E departments of patients facing extended trolley waits."
"Exit blocks" – the inability to move patients elsewhere, even when they have been declared fit to leave hospital – were a major problem. "That could be the lack of transport to get a patient from an acute hospital to a bed in a community hospital, or the fact that there's nowhere for the patient to go," said Mann. "People call it 'bed blocking', but it's not the patients who are blocking the system; it's the system blocking the patients".