The number of hospital beds in England occupied by patients with flu has increased by 70% in a week, NHS England said, as it warned of a “tidal wave of flu hitting hospitals”.

A&Es had their busiest November on record, with doctors seeing 2.31 million patients come through emergency department doors across hospitals in England.

Experts warned that hospitals are running “red hot”, with some predicting winter could be “one of the worst the NHS has faced”.

Health leaders said people eligible for the free flu jab should get vaccinated as soon as possible to avoid “festive flu”, amid the rise in cases.

An average of 1,861 flu patients were in hospitals in England each day last week, including 66 in critical care beds, NHS figures show.

This is up from 1,099 patients the previous week when 39 were in critical care.

It is also more than four times the figure at this point last year.

NHS England said cases of norovirus and respiratory syncytial virus (RSV) are also on the rise.

An average of 837 hospital beds in England were filled each day last week by patients with diarrhoea and vomiting or norovirus-like symptoms, up from 756 the previous week.

There were an average of 152 children with RSV in hospital wards in England last week, up from 142 the previous week and higher than at this point in 2023 (107).

The number of hospital beds occupied each day by patients who had tested positive for Covid-19 averaged 1,343, down slightly week-on-week from 1,390.

Health bosses have warned hospitals are bracing for a so-called “quad-demic” of disease over the winter months, with an increase in cases of flu, norovirus and RSV, coupled with expected increases in Covid-19.

The NHS situation report also shows that 35.8% of patients arriving by ambulance at hospitals in England last week waited at least 30 minutes to be handed over to A&E teams.

Some 16.3% of ambulance handovers last week, or 14,672 patients, were delayed by more than an hour.

Professor Sir Stephen Powis, national medical director for NHS England, said: “The tidal wave of flu cases and other seasonal viruses hitting hospitals is really concerning for patients and for the NHS – the figures are adding to our ‘quad-demic’ worries.

“While the NHS has plans in place to manage additional demand over the busy winter period, with one week left to book your vaccine, I cannot stress enough the importance of getting booked in to protect yourself against serious illness and to avoid ‘festive flu’.”

Health and Social Care Secretary Wes Streeting also urged people eligible for free vaccinations on the NHS to take them “before it’s too late”.

“With A&Es facing record demand, we are continuing to encourage people to protect themselves, their family, and the NHS by getting vaccinated before it’s too late,” he said.

Separate performance data for the health service in England show that the overall waiting list fell October, compared to September.

At the end of October, the waiting list stood at 7.54 million, down from 7.57 million in September.

Some 6.34 million patients were waiting for treatments, with some waiting for more than one appointment, procedure or operation.

Prime Minister Sir Keir Starmer’s “plan for change” pledges that by July 2029, 92% of patients will be seen within 18 weeks for pre-planned care such as hip and knee replacements

But leading surgeons have called on the Government to provide more detail on how the health service in England will meet the 18-week target for waiting times within this Parliament amid growing winter pressures.

Professor Frank Smith, vice president of the Royal College of Surgeons of England, said: “Winter is always a difficult time for the NHS and hospital leaders are already warning this could be one of the worst the NHS has faced. This will have a knock-on effect for planned operations.

“While waiting lists are reducing, they are not coming down fast enough to guarantee the Government will meet its milestone on the 18-week target within this Parliament. We need a clear road map, which outlines annual targets for reducing waits of over a year and the total waiting list.”

Danielle Jefferies, senior analyst at The King’s Fund think tank, said that services are running “red hot”, adding: “The situation in the NHS is fraught as it enters what looks to be a deeply troubling winter.”

Tim Gardner, assistant director of policy at the Health Foundation, said: “Whilst promising progress has been made in recent months, the 18-week target hasn’t been met for nearly a decade. The waiting list remained stubbornly close to record levels in October with more than 234,000 waits longer than 12 months. With the NHS facing the prospect of a very difficult winter, making further headway over the next few months will be very tough.”

Dr Tim Cooksley, immediate past president of the Society for Acute Medicine, said: “Patients continue to experience appalling conditions and prolonged waits for urgent and emergency care – it is an ongoing crisis which remains far from being resolved effectively and it summarises the pressures being seen throughout the system.

“Many hospitals will undoubtedly fall into critical incidents and patient safety will be compromised – but the frustration is that this is not unexpected given the long-standing issues with workforce, capacity, stretched community services and a crisis in social care.”

He warned that emergency departments often become “bottlenecks” with patients unable to get beds in hospitals and corridor care becoming a “normal occurrence”.

“This is dangerous, undignified and a real source of upset for staff as it seriously impacts the ability to care for patients,” Dr Cooksley added.