The winter months will be a severe test for the healthcare sector, the NHS Confederation has said, in response to the release of NHS Improvement’s quarterly performance figures.

Commenting on the latest performance update, Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said: "If it is bad now, and it is, it will almost certainly be worse over the next few months. Flu, norovirus and severe cold are our enemies and we must hope they stay away this winter. A and E departments had to cope with record numbers of patients this summer, this next period will be an even more severe test.

"The challenge is all the greater with more than 100,000 vacancies across the NHS in England. The service simply does not have the staff to do the job.

"The health service has been promised more money and that will help, but the harsh reality is that we face tough choices because the NHS cannot do everything.

"The answer in part lies in developing new types of service to support people in their own homes and in the community to relieve the intolerable pressure in hospitals.

"The long-term NHS plan for England is due out before Christmas – it will not be a panacea, but it must set the right direction of travel that will in time make the health service sustainable – as these figures show we cannot go on as we are."