NHS hospital Birmingham GETTY

NHS closure warnings as doctors say the strain on the services will see the health service ‘implode’

Dr Mark Holland, president of the Society for Acute Medicine, said the days when summer provided respite was over and the health service now faced an “eternal winter”.

He said the a major increase in hospital admissions due to flu or norovirus could prompt a collapse in the health service.

Dr Holland’s warning came as new figures showed waiting times this summer have been worse than for most winters for more than a decade.

One in 10 patients waited for more than four hours in A&E during June, July and August – worse than any winter for the last 12 years bar one, analysis showed.

Only last winter marked a worse performance since the target was launched in 2004.

Data from NHS England for the summer also showed hospitals were missing key targets for cancer, routine operations and ambulance response times.

A&E hospitalGETTY

One in 10 patients waited for more than four house in A & E this summer

Delayed discharges – where patients remain in hospital despite being medically fit to leave – continued to rise, with a record high during August.

The NHS is on its knees and, this winter, areas will implode around the country. There is no reserve left

Dr Mark Holland

Dr Holland said: “The NHS is on its knees and, this winter, areas will implode around the country. There is no reserve left.

“We coined the phrase eternal winter months ago in relation to increasingly poor performance and this data is clear evidence that is what we are now dealing with.

“Over the coming weeks and months, if we see a major increase in admissions due to flu or bed closures due to norovirus, we will collapse.

“The Government has failed to acknowledge or address the scale of the crisis in social care and delayed discharges and, at present, I see no plan of action in place to prevent it derailing the health service.

“If we are unable to discharge patients and release pressure on our emergency departments and acute medical units at the front door, the system grinds to a halt.”

The Local Government Association said a funding gap of at least £2.6billion is opening up for providing social care in the community.

This effects discharges because care packages are not always in place for those leaving hospital.

Nuffield Trust chief executive, Nigel Edwards, said: “Our analysis of hospitals suggests that after years of squeezed bed numbers, there is not enough space left to move patients through at the rate we want. 

“The practice of counting bed use at midnight misses the real crunch points during the day.

“On the front line, leaders should work on better monitoring and control of patient flow minute by minute. 

Surgeons at NHS hospital GETTY

There was also an increase in delayed discharge this summer

“Helping the longest staying patients to leave hospital sooner should be a priority, although it will be difficult with the social care system on its knees. 

“Nationally, we should be realistic about what hospitals can do when they are this full, and how hard it will be to free up space again.”

Almost 2million people attended A&E in August, a 3.6 per cent increase on the same month last year, while there were more than 470,000 emergency admissions.

Matthew Swindells, of NHS England, said: “While hospitals are continuing to look after more than nine out of 10 A&E patients within four hours, and A&E performance improved this month, the CQC report highlights the impact of rising social care pressures on emergency admissions and delays in people leaving hospital.”

Prime Minister Theresa MayGETTY

Dr Mark Holland criticised the government for failing to acknowledge the scale of the problem

The performance shambles come days after Cancer Research UK said 500,000 people can expect to be diagnosed with the killer disease every year by 2035.

Emma Greenwood, of Cancer Research UK, said: “These missed targets represent thousands of cancer patients whose treatment has been slow to start. This is unacceptable. 

“And we’ve highlighted these missed targets for more than two and a half years now. 

“We want to see faster progress to address poor waiting times and ensure the NHS can diagnose all patients quickly.”