Nearly two-thirds of people who arrived at accident and emergency at the Wye Valley Trust last month were seen within four hours, new figures show.
The NHS standard is for 95% of patients to be seen within four hours. However, as part of a recovery plan, the health service aims for 78% of patients to be seen within this time frame by March 2025.
Recent NHS England figures show there were 7,366 visits to A&E at Wye Valley NHS Trust in September. Of them, 4,844 were seen within four hours – accounting for 66% of arrivals.
Across England, 74% of patients were seen within four hours, down from 76% in August.
Figures also show 38,880 emergency admissions waited more than 12 hours in A&E departments from a decision to admit to actually being admitted – up from 28,494 the month before.
The number waiting at least four hours from the decision to admit to admission also increased, from 116,489 in August to 130,632 last month.
At Wye Valley NHS Trust, 738 patients waited longer than four hours, including 284 who were delayed by more than 12 hours.
Siva Anandaciva, chief analyst at health think tank The King’s Fund, said the NHS is approaching winter in "bad shape" as financial pressures are rising, industrial action continues and performance targets are missed.
He added: "Today's statistics show it has been three years since A&E performance was above the current temporary target of 78% of people waiting under four hours and nearly a decade since the official target of 95% of people being seen in four hours was met.
"The Government has made its diagnosis that the NHS is broken, and now they must fix it."
He said the upcoming budget will reveal how far the Government is willing to go to support health and care services ahead of next year's multi-year spending review.
"To govern is to choose, and ministers have some tough choices about how they will balance their significant ambitions to improve health services with the reality of tight public finances."
The NHS said accident and emergency departments experienced the busiest ever September with 2.2 million attendances, and 530,824 emergency admissions. This followed the busiest summer on record.
The overall number of attendances to A&E at Wye Valley NHS Trust in September was a rise of 2% on the 7,238 visits recorded during August, and 25% more than the 5,886 patients seen in September 2023.
Professor Sir Stephen Powis, NHS national medical director, said: "These latest figures show the pressure we saw over the summer is not letting up, with too many patients waiting too long for treatment, following a record September for A&E attendances and 1.2 million more attendances so far this year than before the pandemic."
He added it is likely to be "another incredibly busy winter" with extra demand from Covid, flu, and the cold. He urged those eligible for vaccinations to come forward as soon as possible.
Minister of State for Health, Karin Smyth, said the data is a reminder of the pressures A&Es continue to face.
She added: "With the winter months approaching fast, we have laid out our plans with NHS England to make sure the system is prepared.
"This includes using virtual wards to support patients out of hospital, making sure pharmacies are supporting general practice during this busy period and running the annual winter vaccination campaign, including offering RSV vaccines to vulnerable groups for the first time."