More waiting for hospital admission
There has been a rise in the number of people waiting more than four hours to be admitted to hospital and the number of days lost due to "bed blocking", latest figures show.
NHS England published its weekly round-up of how the NHS is performing as the winter weather starts to bite.
The number of patients who arrived at A&E as an emergency who then waited more than four hours (but less than 12) to be admitted after a decision was made to admit them stood at 3,300 in the week ending November 24.
This is up just over a fifth on the same week last year, when the figure was 2,700.
This is set against a rise in emergency admissions across England, with 104,300 during the week, up from 102,900 in the same week last year.
The percentage of patients spending four hours or less in A&E was 95.7%, down slightly from the 96% in the same week last year.
More beds were "blocked" by patients ready to leave hospital but could not be discharged, the figures also show.
The average number of beds "lost" per day that could have been used by other patients was 3,062, compared with 2,716 in the same week last year.
Last week figures for the whole of October showed the number of days lost due to these delays in transfers was the highest for more than three years.
The number of hospital bed days lost because of delayed discharges was 78,424, up nearly 8,000 on the same time last year, and the highest since monthly data was first published in August 2010.
Of the bed days lost, 15,830 were caused by problems in transferring people to social care, such as finding places in nursing homes.
The new data also shows the number of delays of 30 minutes or more in ambulances handing over patients to A&E is down on last year.
Dame Barbara Hakin, chief operating officer and deputy chief executive of NHS England, said: "This week the NHS continues to deliver a good urgent care service for our patients. This is now the 31st consecutive week A&E departments have treated, admitted or discharged over 95% of all patients within four hours.
"We continue to monitor the situation closely, especially now as the weather has started to get colder. This daily monitoring shows that ambulance handover delays, A&E diverts and cancelled operations are down compared to last year. This is encouraging.
"We have seen a slight increase in the number of delayed transfers of care but, while one is too many, I want to stress that these currently remain within what we would expect at this time of year and should not be over-interpreted. We do, however, want to ensure this does not develop into a more serious problem.
"I have therefore asked healthcare leaders from around the country to take a further look at this issue and see if there is more pre-emptive action that needs to be taken, along with colleagues from social care. We must do everything possible to keep these delays to a minimum."
The challenges during winter "are significant" but "the effort we are putting in to meet those challenges has never been greater and our planning and co-ordination has never been as meticulous nor as advanced at this stage of the year", she said.
A Department of Health spokeswoman said: "Far from showing the NHS is struggling, the latest stats show it is coping well - seeing more patients in A&E and seeing them in less than four hours.
"Many of the 100,000 patients who were admitted to hospitals last week will have begun treatment in A&E.
"The data shows just 600 more patients waited more than four hours to be admitted last week, compared to this time last year."