A&E waiting times reach worst level.

A&E waits in England reached their worst level in January 2019 since the four-hour target was introduced in 2004.

The A&E waits worsened after hospitals appeared to be coping well in the early part of winter.

During January, only 84.4 per cent of patients were treated or admitted in four hours, well below the 95 per cent threshold.

The figures mean that nearly 330,000 patients waited longer than they should with hospitals reporting significant problems finding beds for those needing to be admitted.

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.

The figures worsened in spite of relatively low levels of flu. The last time the target was met was July 2015.

President of the Society for Acute Medicine, Dr Nick Scriven, said it was clear the NHS was under "severe strain.” He said hospitals had seen significant overcrowding with many intensive care units completely full and this had  created a knock-on effect for ambulances, which were being delayed dropping off patients at A&E.

He said "Although there is less minor illness associated with flu this year, there are more severely ill people than last year, which is putting an even bigger strain on the critical care facilities in our hospitals. Any NHS worker will tell you that the stresses and strains are very real and ongoing with no let-up in sight."

Chief economist of the Nuffield Trust think tank, prof John Appleby, said it was clear that the NHS was "fighting a losing battle" in trying to meet its commitments.

He said: "There is a risk that we lose sight of these problems as Brexit distracts us. This situation has a serious impact on hundreds of thousands of patients, and will be demoralising for many staff."

An NHS England spokesman accepted there were significant pressures, but pointed out that, in some respects, performance had improved. When the January figures were combined with December, the winter was slightly better than last.

The spokesman added that more patients were visiting A&E  departments than last year while the mass cancellation of non-emergency treatments ordered in January 2018 did not happen this year.

He added that there was also a sense that the wider system was working better. Delays in patients being discharged from hospital because of a lack of community care to support them had fallen compared to two winters ago, suggesting council care teams and NHS services were in a better position to provide support to hospitals.