A&E waiting times 'at their worst for 10 years': Think-tank says four-hour queues are on the rise The report was compiled by the health think-tank The King's Fund It also included a poll of 48 NHS finance directors A third said quality of care had deteriorated over the past 12 months The number of patients made to wait four hours or longer in A&E has reached its highest level for a decade, a report claims. For the last three months of last year, the figure was 232,000 - an increase of 38 per cent over the previous quarter. Experts said the proportion of patients waiting more than four hours to be seen was the highest since 2003. Trolley wait: Experts say the proportion of patients waiting more than four hours to be seen was the highest since 2003 So-called "trolley waits" - the time accident and emergency departments visitors who need to stay in hospital must wait before they get a bed - were also at their highest rate for ten years. The report, compiled by the health think-tank The King's Fund, also included a poll of 48 NHS finance directors. A third said the quality of care in their area had deteriorated over the past 12 months, while two-thirds said they are concerned about the financial outlook of 2013. The Health Service has been tasked with making £20billion of savings by 2015. It must also contend with considerable reforms introduced by the Coalition. The King's Fund's chief economist Professor John Appleby said: "The NHS faces unprecedented financial pressures, and there are growing worries that patient care will suffer. Health and care services have coped well until now, but it is clear that many organisations expect things to become much more difficult over the coming year. Toxic mix of cuts: Shadow health secretary Andy Burnham has said the survey shows the health care system is heading in the wrong direction Mike Farrar of the NHS Confederation, the membership body for organisations that commission and provide NHS services, agreed. He said: "Despite huge efforts to maintain standards of care and finances, NHS leaders are increasingly concerned about the pressures mounting on their organisations and the knock-on impact of reductions in funding for local government services." He said the findings of the recent Francis inquiry into Stafford Hospital, where hundreds are said to have died due to poor care, "reinforce the fact that we must keep the focus on patients first and foremost." Labour's shadow health secretary, Andy Burnham, said: "This survey provides clear evidence that England's health and care system is heading in the wrong direction. Standards are deteriorating in many parts of the country as the NHS is dragged down by a toxic mix of cuts and re-organisation. Health Minister Lord Howe said: "We have been absolutely clear that the NHS must find the efficiencies needed to deal with increased demand without compromising on patient care and services. We expect the NHS to look seriously at how it can improve how care is provided, particularly to older patients and those with long-term conditions. The report found that NHS bosses" concerns were shared by care providers. Half of social care directors said they thought the quality of their services had worsened in the past year, with a third fearing they would have to reduce services in the coming months.