• NHS England and NHS Improvement have published the latest combined performance figures.
• The figures show the highest number of A&E attendances ever – 4% higher than July last year.
• A&E performance against the 4-hour target has been sitting around the current 86.5% for the last 3 months.
• The waiting list is now 4.4 million – it increased by 10,000 since the previous month.
• The NHS is missing the three key cancer targets – the 2 week wait, 31 day and 62 day.

Responding to the latest monthly performance figures from NHS England/Improvement, the director of policy and strategy at NHS Providers, Miriam Deakin said: "These figures once again show the highest ever number of people seeking emergency and urgent care since records began. This reflects sustained increases in demand for services including from older and frail people which we now see all year round.

"Trusts have not been able to use the summer months to catch up and clear waiting lists as they used to do in the past. The waiting list has now grown to over 4.4 million people and we have missed the key cancer standards for the second month in a row. With over 100,000 staff vacancies and rising demand putting pressure on services, this is leaving more people waiting longer for care.

Trusts have not been able to use the summer months to catch up and clear waiting lists as they used to do in the past. The waiting list has now grown to over 4.4 million people and we have missed the key cancer standards for the second month in a row.

Miriam Deakin    NHS Providers director of policy and strategy

"This paints a concerning picture ahead of what trust leaders already know will be a very challenging winter for the health service.

"This week, we welcomed the government’s capital funding pledge. This additional money will allow a small number of trusts to invest in fixing backlog maintenance issues ahead of the winter, but there is much more to do. We need a longer-term solution to capital investment to improve key services like cancer diagnostics and treatment. We need to put in place more ambulance, mental health, community and hospital capacity to meet growing demand. We also need to see much more support for the NHS workforce, through resolving the pensions crisis and addressing widespread vacancies."