Struggling hospitals have been told to cancel all routine surgery until the end of January amid fears of a winter NHS meltdown.
The National Emergency Pressures Panel, which is chaired by the NHS’s top doctor Sir Bruce Keogh, said the NHS has been under “sustained pressure” over Christmas and needs to free up doctors and nurses to deal with the sickest patients.
Officials have estimated that this could lead to up to 55,000 deferred operations, such as hip replacements.
Cancer operations and time-critical procedures should go ahead as planned, NHS England said.
The delay had already been in force until mid-January, but the panel says the deferral of all ‘non-urgent’ care will now be extended to January 31.
Hospitals have now been told to cancel any day-case and outpatient procedures, which would not require an overnight bed and where patients would typically walk out after being seen.
It also announced that penalties for mixed sex accommodation breaches should be temporarily lifted.
Under NHS rules men and women are supposed to be treated on different wards and breaches can lead to fines.
Sir Bruce said: “I want to thank NHS staff who have worked incredibly hard under sustained pressure to take care of patients over the Christmas.
“We expect these pressures to continue and there are early signs of increased flu prevalence.
“The NHS needs to take further action to increase capacity and minimise disruptive last minute cancellations.”
Underlining the pressures being felt by the health service, one A&E doctor apologised to patients for the “third world conditions” in his overcrowded unit.
Dr Richard Fawcett, a consultant in emergency medicine at the Royal Stoke hospital, tweeted on Tuesday: “As an A&E consultant at University Hospitals of North Midlands NHS Trust I personally apologise to the people of Stoke for the 3rd world conditions of the dept due to #overcrowding.”
Some hospitals have declared themselves at the most severe pressure level while doctors warned that scores are operating at almost full capacity.
The Royal College of Emergency Medicine warned that overcrowding in A&E departments leads to avoidable deaths.
It also cautioned that pressure on the system is leading to lengthy waits and patients being treated in corridors.
Meanwhile a number of ambulance services are also under severe pressure, with one even resorting to taxis to ferry patients to hospital.
The East of England Ambulance Service said that during December 30, 31 and January 1, 13 patients deemed to be low acuity calls were transported to hospital by taxi.
In the last four days, paramedics working for the trust have wasted more than 500 hours waiting outside hospitals to admit patients due to “handover delays”.
A number of hospital trusts have declared that they are Operational Pressures Escalation Level 4 which means: “Pressure in the local health and social care system continues to escalate leaving organisations unable to deliver comprehensive care. There is increased potential for patient care and safety to be compromised.”
Meanwhile the Royal College of Emergency Medicine (RCEM) and the Society for Acute Medicine both issued stark warnings over pressure.
Emergency medicine consultant Dr Adrian Boyle, chairman for quality at the RCEM, said: “Every type 1 emergency department that I know of is under serious and sustained pressure.
“It feels worse than the equivalent period last year.
“This means that ambulances are waiting outside emergency departments waiting to offload, the emergency departments are full, clinical staff are working extremely hard to try and look after these patients, often having to treat patients in corridors, people suffering lengthy delays.
“And we know that excessive crowding within emergency departments is associated with avoidable deaths.”
Dr Nick Scriven, president of the Society for Acute Medicine, added: “The position at the moment is as bad as I’ve ever known.
“Pre-Christmas, 43 trusts were more than 98% full despite 3,000 extra beds in use. I expect this to be at least doubled, maybe trebled today.
“We are seeing a lot of flu-like symptoms but as yet do not know if it is ‘normal’ or the Australasian strain.”
University Hospitals of North Midlands NHS Trust’s medical director Dr John Oxtoby said: “The health system in the North Midlands was under severe and sustained pressure over the Christmas period and this challenging situation has continued into the New Year.
“During this time the emergency departments will continue to see the sickest patients first, which is unfortunately leading to long waits for other patients.”
Baroness Judith Jolly, Liberal Democrat Health Spokesperson, said: “The Conservatives have run the NHS into the ground so much that it can no longer deal with the pressures of an average winter.
“The NHS needs a commitment of money, resources and staffing but this government won’t deliver it.
“The Tories knew winter was coming but have been so distracted by their own internal problems that they have failed both the NHS and the Care services.”