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.
Some 92.3% of patients attending emergency departments were seen within four hours in October against a target of 95% - the lowest figure for the month since current records began in 2010.
The numbers of delayed days where patients were ready to return home or move to another form of care but still occupied a bed rose to its highest level in five years.
There were 160,094 delayed days in October, affecting more than 5,300 patients.
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 a report by 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".
Sasha Karakusevic, author of the report, said: "It is clear that frontline staff across the health and care services are working very hard to do their best for patients.
"But demand is outstripping capacity at present, as it did last winter, and very focused action that addresses the pinch points is needed now."
According to the monthly NHS figures, the target wait time for cancer treatment from GP referral in October was missed for the 18th month in a row. The 62-day wait was hit for just 81.8% of patients, against a target of 85%.
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 more than 1,923,000 attendances at A&E in October - the highest number for the month since current records began in 2010. They included more than 479,000 emergency admissions, a 2.1% increase on the same month last year.
Meanwhile, the NHS 111 service received more than 1,083,000 calls in October, with 91.4% answered within 60 seconds, against a 95% target.
Dr Barbara Hakin, national director of commissioning operations for NHS England, said: "Our staff continue to provide quality services in the face of increasingly high levels of demand throughout the healthcare system."
A Department of Health spokesman said: "We gave the NHS £400 million more to help prepare for winter earlier than ever this year and our hospitals are coping well under pressure, with the vast majority of patients being seen within the four-hour A&E target.
"We are committed to the values of the NHS, which is why we are giving the service an extra £3.8 billion for next year on the back of a strong economy."