The waiting list for NHS treatment has hit a new all-time high, while a record number of people are enduring long waits in A&E until hospital beds are found, new figures show.

Data from NHS England shows the health service struggling to keep up with demand, with people facing long waits for key tests, some cancer checks, and routine and emergency care.

The number of people in England waiting to start hospital treatment rose to 7.1 million at the end of September, up from 7 million in August and the highest figure 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 number of patients waiting 78 weeks was reduced by 73,430 from 123,969 compared to September 2021 as staff “clamp down” on the longest waits, it said.

But there are serious problems in A&E departments, with the number of people waiting more than 12 hours from a decision to admit them to actually getting a bed rising to a new record high.

Some 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.

The number waiting at least four hours from the decision to admit to admission also reached a new peak of 150,922 in October, up from 131,861 the previous month.

A total of 69.3% of patients in England were seen within four hours in A&Es last month, the worst performance on record and the first time it has dropped below 70%.

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.

This latest set of performance data show that standards are at an unacceptably poor level for both patients and staff

Dr Tim Cooksley, president of the Society for Acute Medicine, said: “This latest set of performance data show that standards are at an unacceptably poor level for both patients and staff with an expectation that this will deteriorate further over the winter months.

“Pressures are at unsustainable levels and the results are scant justice for acute care staff who continue to strive to deliver a reasonable quality of care.

“Morale for patients and staff is low, with little expectation of short-term improvement.

“All parts of the NHS are unquestionably struggling.”

With regard to cancer, the proportion of patients who saw a specialist within two weeks of being referred urgently by their GP has dropped to its lowest level on record, the figures show.

Some 251,977 urgent cancer referrals were made by GPs in September, down from 255,055 the previous month but the highest number recorded for the month of September.

However, only 72.6% of patients in England had a first consultant appointment within two weeks that month against a 93% target, the worst performance on record.

Meanwhile, 67.2% of patients urgently referred for suspected cancer were diagnosed or had cancer ruled out within 28 days in September, down from 69.5% the previous month and the second-worst performance in records going back to April 2021. The target, set for March 2024, is for 75% of patients to be seen.

Cancer Research UK chief executive Michelle Mitchell said: “Behind today’s numbers are real people affected by cancer and facing unacceptably long waits for diagnosis and treatment during what is already an incredibly anxious time – real people who continue to be promised better by successive health secretaries, but who nonetheless continue to be let down.”

The data further showed that nearly 6,000 cancer patients waited more than two months from being referred by their GP to starting treatment in September.

Some 15,071 cancer patients started treatment that month after an urgent referral by their GP, but 5,955 of them had to wait longer than two months – the second highest number in records going back to 2009.

Some 60.5% of patients began treatment within two months – also the second lowest percentage on record and well below the 85% target.

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.”

Shadow health secretary Wes Streeting said: “Millions of patients are waiting months and even years for treatment, often in serious pain and discomfort.

“In an emergency, patients are left waiting hours for an ambulance or entire days in A&E. For many this means being unable to work and putting their lives on hold.”

Fiona Myint, vice president of the Royal College of Surgeons of England, urged Chancellor Jeremy Hunt to commit to a workforce plan to tackle staff vacancies.

“The NHS is desperately in need of a full squad to deal with the record waiting list,” she said.

The data also showed 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 an MRI scan, non-obstetric ultrasound or gastroscopy.

This is up from 461,400 the previous month and the highest number waiting since August 2020 when 472,517 patients had been waiting longer than six weeks.