Substantial rises in demand for care will mean a more difficult than usual winter for the NHS, according to the King’s Fund’s latest quarterly monitoring report.

The health service is currently treating more patients than ever before according to the figures, which cover July to September 2016.

GP referrals have increased by about 3% over the last year and emergency admissions via A&E are 4% higher than the same quarter in 2015.

For the first time, the report includes specific analysis of general practice demand. Data from more than 200 practices showed that an almost 10% increase in patient contacts (including telephone consultations) over the past two years, confirming the huge pressures on general practice.

This is putting increasing pressure on NHS services, which are struggling to maintain standards of care as a result, and the King's Fund is concerned that the NHS is headed for its worst winter ever.

The monitoring report shows:

  • 4% of those attending A&E waited more than four hours, which is the worst performance for this time of year for more than a decade
  • 4% of patients waited longer than 18 weeks to begin hospital treatment, the worst performance since targets were revised in 2012
  • 568,774 bed days were lost as a result of delays in discharging patients from hospital; this is 29% higher than in the same quarter last year

The rise in delayed discharges is linked to cuts to social care budgets and other problems in coordinating care. The King’s Fund, and other organisations, have called for the Chancellor to make more money available for social care in next week’s Autumn Statement.

The NHS is meant to stabilise its finances in 2016/17 but nearly a third of NHS trusts forecast that they will miss their ‘control total’ financial targets. This is up from 13% in the last quarter.

The situation may worsen later in the year also as 20% of CCGs are relying on the ‘risk reserve’ (made up of 1% of CCG budgets) to meet their financial targets, and 70% are concerned about meeting efficiency targets.

Chris Ham, Chief Executive of The King’s Fund, said: “The NHS needs to redouble efforts to manage demand and this will require investment in out-of-hospital services via the sustainability and transformation plans now being developed across England.

“The most pressing priority for next week's Autumn Statement is to provide more funding for social care, following years of budget cuts. Not only would this benefit some of the most vulnerable people in society, but it would also help relieve pressure on the NHS.”