Responding to the latest monthly combined performance data from NHS England and NHS Improvement, and the first week of winter reporting data, the deputy chief executive of NHS Providers, Saffron Cordery said:

"There is no doubt that the winter ahead is going to be extremely tough for the NHS – it is grappling with the usual seasonal pressures, the second wave of COVID-19, the need to restore routine services, and the potential impact of a 'no deal' Brexit. Alongside this we must remember that the workforce, having worked tirelessly for months on end, is exhausted.

"The first week of formal winter reporting shows emergency care is in a better position than this time last year. While this is welcome news we must remember that this data reflects reduced attendance at A&E due to national and regional lockdowns. However, as seen in the monthly performance figures also released today, the high number of people waiting longer than 12 hours to be admitted is concerning, both in terms of patient experience and its potential to lead to A&E overcrowding.

The monthly figures show that NHS activity levels continue to improve.

Saffron Cordery    Deputy Chief Executive

"The monthly figures show that NHS activity levels continue to improve. We are now seeing similar cancer activity levels to before the pandemic and the number of diagnostics tests continue to increase. Tackling the number of patients now waiting over 52 weeks is a top priority for trust leaders, but it is encouraging to see that the number of operations has increased by 465% since April. This highlights just how hard trusts and staff are working, despite the challenges, to restore important routine services.

"Running NHS services is now much harder than usual given the stringent infection control requirements and the need to 'cohort' patients according to their COVID status. Hospital trust leaders are telling us that they have lost between 5 – 20% of their usual capacity. Wards are being repurposed, cumbersome PPE is being donned, and meanwhile many staff are self-isolating or shielding.

"These pressures are being felt right across the system – in acute, mental health, community and ambulance services, as well as in primary and social care settings.

"We must brace ourselves for the long winter ahead."