The NHS is now facing a “quad-demic” of disease going into winter amid rising cases of flu, Covid-19, norovirus and respiratory syncytial virus (RSV).

NHS national medical director Professor Sir Stephen Powis said ambulances are facing huge demand with flu and norovirus numbers in hospital rising sharply.

“For a while there have been warnings of a ‘tripledemic’ of Covid, flu and RSV this winter, but with rising cases of norovirus this could fast become a ‘quad-demic’,” he said.

The Royal College of Nursing warned there is a “barely a spare bed in the NHS.”

The total number of NHS hospital beds has fallen by more than half since the late 1980s, from 299,000 in 1987-88 to just 141,000 by 2019-2020.

NHS Providers, a membership organisation which takes part in negotiations between trusts and the Department of Health, called for a “healthy dose of realism” after the government vowed that 92 per cent of patients will be seen within 18 weeks for pre-planned care by July 2029.