Delayed transfers of care in August hit their highest level since monthly data started being collected six years ago.

There were 188,340 bed days affected by delays, with 6,448 patients measured as delayed on the last Thursday of the month. Both figures were the highest since August 2010 – when data was first collected in this form – and the total bed days “lost” was nearly 30 per cent higher than August 2015.

The figures have been published on the day the Care Quality Commission chief executive David Behan called for “urgent action” to mitigate the impact social care was having on secondary care performance. Mr Behan said there was “clearly” a link between the funding crisis in adult social care and increases in emergency attendances, emergency admissions and delayed discharges.

Overall, the performance statistics for August showed a system under severe pressure and failing to meet targets.

Against the referral to treatment target of 18 weeks, performance was 90.9 per cent – worse than July’s 91.3 per cent and continuing a slow decline over the last year. The number of people on the waiting list for elective care – 3.69 million – has increased by over 11 per cent since August 2015. More than 1,000 people have been waiting for more than a year for treatment, despite the focus on reducing this list over the last few years. The true figure is likely to be higher as eight trusts did not submit data – including some known to have problems with long waiters – while one submitted incomplete data.

The accident and emergency four hour target was missed, with only 91 per cent of patients treated, admitted or discharged within that time. While this was a slight improvement compared with earlier in 2016, the figure for August last year was 94.3 per cent. The 95 per cent target was last met in July 2015. From September 2015 performance declined sharply.

Ambulance response figures were also far below the target with only 70 per cent of the most urgent cases – red one calls – being reached in eight minutes and 63.8 per cent of red two calls being reached in the same time. The target for both is 75 per cent.

Two key cancer targets were not met. The 85 per cent standard for patients starting treatment within 62 days of an urgent GP referral was missed, with just 82.8 per cent of patients being seen within this time. The two week wait for referrals with suspected breast cancer was missed at 92.2 per cent against a target of 93 per cent. Both were slightly better than performance last year and the other six cancer targets were met.

The performance comes against a backdrop of increasing demand: A&E attendances in August were up by 3.6 per cent year on year and the number of diagnostic tests and patients starting consultant led treatment were both up significantly, as were calls to ambulance services.