Latest weekly figures published by NHS England show flu cases up by 350% and norovirus cases up 86% year-on-year, combined with rising Covid and RSV levels.

NHS national medical director, Professor Sir Stephen Powis, said: ‘For a while there have been warnings of a "tripledemic" of Covid-19, flu and RSV this winter, but with rising cases of norovirus this could fast become a "quad-demic" so it's important that if you haven't had your Covid or flu jab to follow the lead of millions of others and come forward and get protected as soon as possible.'

There was a record average of 96,587 patients in hospital beds for the latest week ending 1 December. Of these, an average of 1,099 had flu, 1,390 had Covid, 756 had norovirus and there were 142 children with RSV.

There were thousands more patients arriving via ambulance (up from 83,873 to 90,514), and 35,022 hours lost to handover delays, up 87% from 18,703 this time last year.

Over 400,000 (413,426) calls were made to NHS 111 with 73.1% answered within a minute, up 4.4% up on last year.

An average 11,969 beds were occupied by patients who were ready for discharge, taking up one in eight of all occupied adult general and acute beds (96,587).

Interim chief executive of NHS Providers, Saffron Cordery, said: ‘Hospitals, mental health, community and ambulance services will continue to do everything they can to treat patients as quickly and as safely as possible as we head into the tricky winter months.'

Liberal Democrat health and social care spokesperson Helen Morgan MP said: ‘Ministers need to urgently set forward plans to winterproof the NHS, as we have been calling for months now, and make sure this is the last winter crisis patients and the health service ever experience.'

Health and social care secretary Wes Streeting said: 'For too long, an annual winter crisis has become the norm. We will deliver long-term reforms through our 10-Year Health Plan that will create a health service that will be there for all of us all year round.'