The NHS has seen one of its worst months on records with tens of thousands of patients waiting on trolleys for a bed as emergency departments reported unprecedented demand.

New data published on Friday showed a dire performance across a range of measures in November – before the worst of the winter has really started.

Almost 30 per cent of patients in major hospital A&E departments waited longer than four hours to be seen, a 10 per cent increase compared to the same month last year and the worst performance on record.

For the first time, not one major A&E department in England met the four-hour waiting-time target.

Across all A&E departments, 81 per cent of patients were seen within four hours, a record poor performance against the target of 95 per cent which hasn’t been met since July 2015.

Hospitals are very busy and dangerously full, even though the weather has been mild and flu is not a major problem, NHS figures show.

Record numbers of people in England sought help at A&E, had to be admitted to hospital or waited longer than the maximum 18 weeks for a planned operation in November, according to data released on Thursday.

The intense pressures on NHS services prompted warnings that this winter could prove even tougher than last year, when it experienced its worst ever winter crisis.

“Despite the extensive preparations by trusts, today’s figures make it very clear that the NHS is on course for a very difficult winter,” said Miriam Deakin, the director of policy and strategy at NHS Providers, which represents NHS trusts.

The latest performance statistics show that hospitals missed a host of waiting-time targets as they treated unusually high numbers of patients for the time of year:

• 87.6% of patients arriving at A&E were treated within four hours, far off the 95% target and the lowest proportion ever for November.

• 94.2% of hospital beds were full last week, well above the 85% figure that evidence shows is the safe limit for bed occupancy.

• A&E units had to divert patients to another hospital 25 times last week, of which 11 occurred at the troubled Worcestershire acute hospitals trust.

• 10,675 patients had to spend at least 30 minutes with ambulance crews before being handed over to A&E staff, in breach of NHS rules which say that should never happen.

• Almost 55,000 patients spent at least four hours on a trolley while they waited to get a hospital bed.

• 405 urgent operations were cancelled in October, 42% more than the 287 cancellations a year before.

The NHS is already “operating in the red zone”, the King’s Fund said.

As the cold bites, a report says public investment in warm homes in England has been cut by 58% since 2012.

It says Scotland now spends four times as much per citizen as England on energy efficiency.

The report from the energy think tank e3g urges government to make warm homes a national infrastructure priority.

The government did not challenge the figures, but it said that spending on homes was now better targeted at poor households.

According to e3g’s report, England has the second worst record on cold weather-related deaths out of 30 European countries.

The last five years saw an average of 32,000 excess winter deaths in the UK, with 9,700 each year estimated to be linked to living in cold homes.

The drop in investment happened when David Cameron’s government ended all taxpayer-funded energy efficiency programmes in England.