ASN director and NHS Confederation deputy policy director Jo Webber said

"There is no doubt that the NHS is coming under extreme pressure as finances are so tight and the service undergoes a fundamental re-organisation.

"Despite these pressures, the ambulance service continues to get to more and more people within target times and is offering better care. Hospitals also continue to stay overall within target for the 4 hour waiting time target.

"When the system is under pressure, it is usually at the boundaries between organisations that you see the signs of strain. For example, trusts may struggle to find suitable community or social care to safely discharge people to which in turn means fewer places available for those coming in via A&E.

"Getting this right requires all parts of local health and social care systems to work together to make sure care for patients is as safe and efficient as possible."