The NHS in England has missed a raft of key targets for A&E waiting times, cancer treatment and ambulance responses as experts warned the health service will struggle to cope with the busy winter period.
Monthly figures have shown 92.3% of patients attending emergency departments were seen within four hours in October - against a target of 95%.
It is the lowest figure for October since current records began in 2010.
The 62-day wait for cancer treatment from GP referral was hit for just 81.8% of patients, against a target of 85%. It is the 18th month in a row it has been missed.
Ambulance trusts also continued to miss the target for 75% of critical "Red 1" calls - such as for cardiac arrest - to be responded to within eight minutes. In October this was hit for 73.3% of calls, the fifth month in a row it has been missed.
Some 68.8% of "Red 2" immediately life-threatening calls - such as for stroke - were responded to within eight minutes, against a target of 75%. This target has not been met by the NHS since January last year.
There were 1,923,326 attendances at A&E in October - the highest number for the month since current records began in 2010. It is 1.6% more than October last year .
The figures were published after an NHS research body warned that the health service will struggle to cope over winter because of high bed occupancy rates and a lack of funding.
Just 3.6% of patients took up over a third of all bed capacity in acute hospitals in England last year, according to the Nuffield Trust.
It said the figures help explain why the NHS still suffered a winter crisis last year, "despite receiving extra funding from NHS England of almost £700 million specifically to deal with pressures caused by winter".
The patients taking up a third of bed capacity are "likely to have been frail or elderly people who the system was not ready to return to their own homes or to nursing or residential homes, despite their medical treatment being finished", the trust said.