Sir Simon Stevens
The NHS will move back to its highest alert level from midnight tonight in anticipation of a wave of coronavirus hospital admissions in the coming weeks.
Sir Simon Stevens - NHS England's chief executive - said the move to level four was in response to the 'serious situation ahead'.
The health service was originally put on a level four alert in March ahead of the first wave of the epidemic, but it was downgraded in August when England successfully flattened its curve through lockdown.
However, a mid-September surge in cases has resulted in thousands of coronavirus-infected patients pouring into hospitals across the country in recent weeks, particularly in hotspots in the north. There were fewer than 500 Covid-19 patients in England's hospitals at the start of September, compared to more than 10,000 now.
A move to level four means health bosses believe there is a real threat that the influx of Covid-19 patients could start to disrupt other vital services on a national scale.
Triggering the alert means all trusts have to report to NHS England centrally so it can track capacity levels in every region.
Sir Simon claimed the NHS is currently treating the equivalent of 22 hospitals' worth of Covid-19 patients. But he urged people without Covid-19 not to stop using the NHS.
He said: 'The facts are clear, we are once again facing a serious situation. This is not a situation that anybody wanted to find themselves in, the worst pandemic in a century, but the fact is that the NHS is here.
'The public can help us help you so our fantastic staff - our nurses, our doctors, our paramedics - can get on with looking after you and your family there when you need it.'
Leaked documents, seen by The Telegraph, revealed intensive care units are no busier than normal for this time of year for most trusts, pouring extra cold water on claims the NHS is close to being overrun
It comes after a leaked document showed hospital bed occupancy this year dropped to its lowest percentage for a decade when medics had to turf out thousands of inpatients to make room for a predicted surge in people with Covid-19. Now that normal care has resumed, a leaked report suggests there are still fewer than average numbers of beds in use
Sir Simon claimed the health service had filled 'another two hospitals full of severely ill coronavirus patients' since Saturday, when Boris Johnson announced the second national lockdown.
No10 justified the blanket draconian measures on frightening projections that the NHS could run out of beds within weeks.
Echoing the gloomy warnings of No10's top scientific advisers, Sir Simon told BBC Radio 4's Today programme that by the end of November, there will be more Covid patients than there were during the first peak in April.
Sir Simon today admitted, however, that the NHS never ran out of room during the first wave and claimed that the national lockdown will mean the health service continues to have space throughout the winter to keep up normal services and tackle backlog created from cancelling thousands of operations in the first wave.
Thousands of beds went unused after bosses decided to scrap non-urgent operations to make way for predicted onslaught of coronavirus patients. Make-shift Nightingale units were left virtually empty.
Sir Simon's comments come after leaked documents today revealed intensive care units are no busier than normal for this time of year for most trusts, pouring extra cold water on claims the NHS is close to being overrun.
Eighteen per cent of critical care beds available across the health service nationally, which is normal for the autumn.
Data from the NHS Secondary Uses Services, seen by The Telegraph, claims to show that even in the worst hit region, the North West, seven per cent of critical care beds are still free.
Experts said hospitals are running 'at normal levels', in stark contrast to the picture which is being painted by the Government, which has honed in on the small handful of hospitals that are under more pressure than in the spring.
It comes as MPs prepare to vote on a new four-week Covid-19 lockdown for England.
But Boris Johnson is facing a Tory revolt in a crunch Commons vote today - with fears he will have to rely on Labour to get the plan through.
The draconian measures, ordering people to stay at home and shutting non-essential retail, bars and restaurants for a month, are set to come into force from midnight.
But while Sir Keir Starmer's backing means the PM is assured they will be rubber-stamped by MPs this afternoon, he is scrambling to contain a rising tide of anger on his own benches.
The number of Covid-19 patients in English hospitals has soared almost five-fold from 1,995 on October 1 to 9,213 on the 31st, Department of Health data shows.
'In a sense the facts speak for themselves,' Sir Simon told BBC Radio 4's Today programme this morning.
'We began early September with under 500 coronavirus patients in hospitals by the beginning of October that had become 2,000 and as of today that is just under 11,000.
'Put another way we've got 22 hospitals worth of coronavirus patients across England and even since Saturday when the Prime Minister gave his press conference we've filled another two hospitals full of severely ill coronavirus patients.'
Sir Stevens' comments add further confusion to whether NHS hospitals are truly overwhelmed, after documents from the NHS Secondary Uses Services (SUS), a body which provides data for purposes such as healthcare planning, shows capacity in ICU was on a normal path in October.
NHS hospitals in England appear quieter than usual for this time of year even though they are treating more than 9,000 patients with coronavirus.
A leaked document claims 84 per cent of all hospital beds were occupied across the country yesterday, which is lower than the 92 per cent recorded during autumn last year.
Bed occupancy has not averaged lower than 85 per cent in any normal three-month period for the past decade.
The only exception to this was between April and June this year, when it stood at 64 per cent because hospitals were forced to turf out thousands of non-Covid patients to make space for the epidemic.
Regional differences in the coronavirus outbreak mean some places are feeling more strain than others – one major hospital trust in Liverpool is already be treating more Covid-19 patients than it was in the spring.
Medics fear the numbers of people needing care for Covid-19 will become so large that they won't be able to treat people with cancer and other serious diseases.
Doctors already face a huge backlog in cancelled or postponed non-urgent operations and procedures, on which they are now desperately trying to catch up. A resurgence in people who need saving from Covid would put this progress in jeopardy.
But the data obtained by the HSJ shows that hospitals are less full than usual despite having 70 per cent more patients than they did in the spring.
They have around twice as many non-Covid patients – more than 70,000 on wards as of yesterday – along with 9,000 coronavirus patients, and still have at least 10,000 beds available.
At the most recent measure – during the first quarter of 2020/21 – the NHS had a total of 118,451 beds available, of which 92,596 were general hospital beds. The others were on maternity, mental health and learning disabilities units.
This is not thought to include capacity in Nightingale hospitals or private wards that have been rented out. Thousands of beds were put on standby when ministers feared a catastrophic wave of patients with coronavirus, but many were never used.
Full data has not been published about daily bed occupancy and the NHS is coming under growing pressure to show the real state of pressure on its hospitals.
Figures seen by The Telegraph show there is still 15 per cent 'spare capacity' across the country – fairly normal for this time of year.
That's even without the thousands of Nightingale hospital beds which will provide extra capacity if needed.
Even in the North-West, the worst affected region in the 'second wave', only 92.9 per cent of critical care beds are currently occupied.
And in the peak of the Covid outbreak in April, critical care beds were never more than 80 per cent full, according to the data.
There were around 5,900 critical care - or ICU - beds in the NHS in January 2020, according to the King's Fund.
It is not clear how many Covid-19 patients are on critical care wards as this data is not available. But the number of patients on a ventilator - 952 on November 3 - gives a rough idea. However, not all patients on ventilators are classed as being in ICU.
The SUS documents show there were 9,138 Covid-19 patients in general hospital beds in England as of 8am on November 2.
Yesterday this figure was 10,377 - the highest it has been since the beginning of May but following a drop of patients in hospital at the weekend.
It means Covid-19 patients are accounting for around 10 per cent of general and acute beds in hospitals, which has gradually been increasing over the month of October.
However, there are still more than 13,000 beds available on general wards, considering there are almost 114,000 NHS beds in England overall.
MailOnline revealed at the height of the first wave in April that Covid-19 patients never made up more than 30 per cent of the total beds occupied. Just under 19,000 patients out of 70,000 in hospitals at that time had Covid-19.
An NHS source told The Telegraph: 'As you can see, our current position in October is exactly where we have been over the last five years.'
Commenting on the new data, Professor Carl Heneghan, director of the Centre for Evidence-Based Medicine at the University of Oxford, said: 'This is completely in line with what is normally available at this time of year.
'What I don't understand is that I seem to be looking at a different data-set to what the Government is presenting.
'Everything is looking at normal levels and free bed capacity is still significant, even in high dependency units and intensive care, even though we have a very small number across the board. We are starting to see a drop in people in hospitals.
'Tier Three restrictions are working phenomenally well and, rather than locking down, I would be using this moment to increase capacity.'
The leaked documents also show that no intensive care units are in Covid-19 Pandemic Critcon levels above two.
Critcon levels - used to give an idea of how stretched a hospital is - at three and four are enacted during a 'full stretch' and 'emergency', when other wards need to be used for critical care.
An intensive care consultant has said the number of coronavirus cases looks worse than 'even gloom-mongers like me had feared'.
Dr Richard Cree works at the James Cook University Hospital in Middlesbrough and writes on his nomoresurgeons.com blog about his role.
In a post on Tuesday, he said that there were 93 Covid-19 patients in the hospital at the weekend, with 'significant numbers' requiring continuous positive airway pressure on the three coronavirus wards, and more ventilated patients in intensive care.
Dr Cree said when the government's leading scientists presented the worst-case scenario in September, growth of cases was low and deaths even lower.
He wrote: 'As a result, most people refused to believe such a prophecy. It turns out that everyone was wrong and that the situation looks much worse than even gloom-mongers like me had feared.'