A top emergency doctor has warned of the worst winter ever for the NHS's emergency wards, after figures revealed a huge increase in patients facing long waits since 2011.
Cliff Mann, president of the College of Emergency Doctors, which represents A&E medics, said recent NHS England figures for waiting times were a "cause for grave concern".
The figures show the number of patients waiting more than four hours in emergency rooms has jumped by 43 per cent since September 2011 and the number of "trolley waits" of four to 12 hours is up 89 per cent since then.
Mann told The Guardian: "All the worrying indicators are up already. And they seem to indicate that this winter will probably be worse than last winter, which was the worst we have ever had, a tipping point for the NHS's delivery of acute care.
"It's not chaos in emergency departments, but it is a crisis. Colleagues at hospitals report that there are almost daily instances in most A&E departments of patients facing extended trolley waits."
The figures show that waiting times this summer eclipsed those during recent winter months, when things are usually worse. For example, 17,037 waited more than four hours during a single week in mid-August, compared with 16,479 during a week in mid-January 2011.
Shadow health secretary Andy Burnham accused ministers of leaving the service "on the brink of its most dangerous winter in years."
He said: "These worrying new figures expose the intense pressure that England's A&Es and hospitals are under. Too many are already sailing dangerously close to the wind, and that is before the winter has even started."
A Department of Health spokesman said: "We know the NHS is under increasing pressure, but A&E departments have still been seeing 95 per cent of their patients within four hours since the end of April. This is testament to the hard work of staff.
"More work needs to be done, so we are investing £500 million over the next two years to help A&E departments through winter. Longer term, our £3.8 billion integration fund will focus on joining up health and care services, keeping people healthier and treating them closer to home."