LONDON: Routine hospital appointments are to be delayed to free up capacity for the sickest patients until the end of January, amid warnings of extreme pressure facing A&Es across the country.

The NHS has taken the drastic step of extending the cancellation of non-urgent operations to include thousands more minor procedures this month, amid multiple reports of NHS services struggling to cope this Christmas.

Officials have estimated that this could lead to up to 55,000 deferred operations.

The move comes as a senior NHS consultant apologised for the “third world conditions” some patients are experiencing.

Dr Richard Fawcett, a consultant in emergency medicine in Stoke-on-Trent, one of the country’s largest A&E departments, 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 third world conditions of the department due to overcrowding.”

This followed an earlier tweet saying the A&E department had already had to divert ambulances to other hospitals because of demand.

The intense pressures facing the NHS were confirmed by new guidance from the NHS National Emergency Pressures Panel (NEPP) which, before Christmas, told trusts to cancel non-urgent operations - such as cataract surgery and hip replacements - to manage winter pressures.

This temporary block has already led to tens of thousands of operations being cancelled, and has now been extended from mid-January to the end of the month.

But 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.

In a further sign of the pressure on bed space, the NEPP guidance also says that penalties for providing beds for men and women on the same wards should not be enforced.

The Independent has previously shown use of mixed sex wards was spiralling, despite a Conservative pledge to abolish them.

The NEPP is chaired by former national medical director Professor Sir Bruce Keogh, who thanked staff for their work over Christmas and said: “We expect these pressures to continue and there are early signs of increased flu prevalence.”