By Thomas Moore, Health Correspondent
It will be 'very, very tough' for the NHS to avoid a repeat of last winter's A&E care crisis, Jeremy Hunt has warned for the first time.
In an exclusive interview with Sky News, the Health Secretary admits to being "concerned" about the high demand for emergency care and the pressure staff are under.
Asked how confident he is that patients will not experience a repeat of the long waiting times seen last year, Mr Hunt said: "It is going to be very, very tough.
"But we can get through this winter. It is entirely possible to meet A&E targets, and I am determined we should."
His warning comes as a poll commissioned for State Of Emergency, Sky News' weekend of live coverage from Nottingham's Queen's Medical Centre, shows that two thirds of people - 66% - believe A&E services are in crisis and patients are being put at risk.
Sky News is broadcasting from inside the Queen's Medical Centre, Nottingham The Sky News poll of 1,106 people carried out by Survation also shows that more than eight in 10 (81%) of people believe the Government must take immediate action to avoid major issues in A&E.
And 65% blame government cuts for any staff shortages and poor levels of care. However, 75% of those questioned agreed that doctors and nurses were trying their best but were being worked too hard.
The poll also found that a large majority of people - 72% - believe that people visiting A&E for injuries sustained while drunk or under the influence of recreational drugs should have to pay extra towards the cost of treating them.
And more than 90% oppose the provision of breast enlargements and tattoo removals on the NHS.
To address the A&E care crisis, almost two thirds of people - 65% - think that consultants should be forced to work weekends and nights, with 43% saying that senior doctors who refuse should receive less pay.
Some 65% of those questioned also believe that NHS managers are paid too much.
Heath Secretary Jeremy Hunt In the first three months of this year, 94 out of 148 hospital trusts failed to meet the target for treating 95% of patients within four hours of them arriving at A&E.
Although the pressure eased over the summer, waiting times have begun to climb once more. Some hospitals are already breaching the target, even before winter pressures kick in.
The government has given the NHS an extra £500m to pay for short-term measures over the next two years to help ease the pressure.
That could include employing more locum consultants in A&E departments and setting up GP surgeries inside hospitals.
"A lot of things are happening to give support to the front line," said Mr Hunt.
"But that's not to say we are not worried about it, because it is going to be very tough, and we understand that."
The National Director for Acute Episodes of Care for NHS England, Professor Keith Willett, told Sky News that demand for emergency care is likely to rise once again this winter.
He will shortly unveil plans to divert more A&E patients towards the care of GPs, paramedics and chemists.
But in the short term, patients will have to accept they have to wait for care.
"Safety is the priority," he said. "We will do everything we can to maximise the way patients receive their care as quickly and optimally as possible.
"But it is a pressured system and we have to work within the envelope we have and the skills and staff we have."
*As part of the poll 1,106 adults were surveyed on September 2-3 by Survation on behalf of Sky News.
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