Ambulance trusts are struggling to meet the target to get to a patient within eight minutes of an emergency call, the latest data from NHS England shows.
A high number of trusts also continue to fail to report their waiting lists for elective treatment.
The latest performance data, which covers August, shows longer ambulance response times and a growing elective waiting list.
Nine trusts did not report their waiting lists for the end of August. This includes Great Ormond Street Hospital for Children Foundation Trust, which did not submit waiting times data for the first time.
A note in the trust’s September board papers said the national elective intensive support team reviewed its waiting list practices and found “inconsistent application of the trust’s access policy”. A further investigation found the data was “unreliable”.
NHS England wrote to the nine in July, saying a “much more stringent approach” will be taken with trusts that do not report their referral to treatment data from this month, when the penalty for breaching the remaining RTT target will be increased.
Ambulance trusts failed to send out response vehicles to an increasing number of patients in August.
Only 73.6 per cent of the most serious calls, called red 1, received an ambulance within eight minutes. This was the worst performance in five months.
There were 13,813 red 1 calls in August, following 13,959 in July, when 74.5 per cent of calls were responded to within eight minutes.
Ambulances responded to 69.7 per cent of red 2 calls, which cover all life threatening emergencies apart from respiratory problems or cardiac arrest, within eight minutes. In July 70.6 per cent received a response in eight minutes.
There was a slight increase in red 2 calls in August, with 254,524 calls compared to 252,506 in July.
The RTT waiting list continues to grow and NHS England estimated there “may have been just over 3.5m patients” waiting to start treatment at the end of August if the trusts who did not report their waiting lists are included.
The waiting list has grown by 7.7 per cent since August last year.
There were 246,271 patients waiting over 18 weeks to start treatment, the highest number since July 2011. However, the sector still managed to meet the target for 92 per cent of patients to start treatment within 18 weeks with 92.6 per cent patients starting treatment.
There were fewer patients admitted per working day than in July. There were 14,306 patients admitted per working day in July compared to 14,225 in August.
Hospitals continued to struggle with poor accident and emergency performance with only 91.5 per cent of patients in major A&Es seen, treated, admitted or discharged within four hours.