Chris Hopson, chief executive of NHS Providers, said emergency care is “under particular strain” and that increases in ambulance response times and trolley waits are “very concerning”.

“Trust leaders are deeply aware of the obvious risks to patient safety here and are doing all they can to manage these risks,” he said.

Response times for life-threatening ambulance calls, including for heart attacks, was nine minutes and 35 seconds on average in March – the highest on record. This is up two minutes and 35 seconds from the same month pre-pandemic, and far higher than the seven minute target.

For category three urgent calls – such as late stages of labour, non-severe burns and diabetes – response times averaged three hours, 28 minutes and 13 seconds, again the highest on record.

This is up more than an hour from the previous month, when the average was two hours, 16 minutes and 13 seconds.

NHS England said that despite record volumes of 999 calls and ambulance call-outs for life-threatening conditions over the winter period of December to March, the service had managed to cut the numbers waiting the longest for hospital treatments.

A total of 23,281 people in England were waiting more than two years to start routine hospital treatment at the end of February, down slightly from 23,778 at the end of January.

But it is around nine times the 2,608 people who were waiting longer than two years in April 2021.

‘Come forward for the care you need’

Data released under Freedom of Information this week found some patients are waiting up to four years to start treatment.

The NHS elective recovery plan sets the ambitions of eliminating all waits of more than two years – except when it is the patient’s choice – by July, and all waits of more than a year by March 2025.

Professor Stephen Powis, NHS England national medical director, said: “Nobody should be under any illusion about how tough a job NHS staff have on their hands, balancing competing priorities and maintaining high quality patient care.

“Despite pressure on various fronts and the busiest winter ever for the NHS, long waits fell as staff continue to tackle two-year waits by July thanks to the innovative approaches to care they are now adopting – from same day hip replacements to dedicated mobile hubs for operations.

“As ever, if you need help, especially over the often busy bank holiday weekend, please do come forward for the care you need through NHS 111 online and if it’s an emergency, dial 999 or go to your nearest A&E.”