Hospitals are already full up to 99% as the NHS prepares for winter: far more than the 85% limit that experts say should be maintained to protect patient safety.
The hospital's trusted executive directors have revealed that almost 100% of bed occupancy is working, even before the expected bad weather and the main flu outbreak come this winter.
NHS chiefs who spoke on condition of anonymity also expressed fears that patients might suffer damage and that staff could not cope with the seasonal increase in demand for care because their hospitals could run out of beds.
"We are lucky to get bed occupancy rates of less than 99%," said the executive director of a trust. "We plan for winter throughout the year, but there is an underlying lack of beds and resources, there is a daily battle [over where to care for patients who need to be admitted] due to the lack of beds."
The chief executive admitted to be concerned about the chronic lack of beds that put patients' health at risk. "In terms of extreme pressure, we worry, we worry about getting people to lie down fast enough."
Another trusted chief executive said: "We have 98% capacity and 11% of our beds are occupied by delayed patients in the transfer of care [who are medically fit to be discharged but cannot leave as social care support is not available]. Every day we have 80 to 90 patients in beds that should be somewhere else. "
The combination of bed shortages and what the NHS calls Dtocs is a real concern because of its potential impact on the quality of care, the chief added.
International health experts agree that if more than 85% of beds are occupied, there is a greater risk that patients will acquire infections such as Clostridium difficile and MRSA, ending up in rooms that are not suitable for their disease and that receive inadequate attention.  The NHS admitted last month that a £ 1bn effort to release between 2,000 and 3,000 hospital beds in England this fall had failed. The initiative has significantly reduced delayed transfers of care in only a few areas, it has been asserted.
Hospital leaders are also concerned that the shortage of beds in the residences will deny them the possibility of expanding the number of patients they can afford paying the operators of the residences to care for some elderly people. in winter to relieve the pressure.
Chris Hopson, executive director of NHS Providers, which represents hospital trusts, said: "It is worrisome to know that occupancy rates in some places approach 100% before the winter begins."  "The health service can be harshly evaluated in the coming months, since it is about to reach its maximum potential".
Hopson said that while the government's recent injection of emergency funds for £ 337 million was welcome, it was too late to make a big difference in the winter planning of hospitals.
NHS Providers also warned in a report published Thursday that the health service is critically short of paramedics, general practitioners, doctors and nurses of A & E.
NHS leaders say they fear that staff agencies may exploit the delayed arrival of emergency government funding and the serious shortage of health service personnel to increase the fees they demand for the supply of doctors, nurses and nurses. other staff
"These figures are very worrying and show an NHS that is now struggling to find free beds throughout the year.The UK already has fewer beds than the equivalent European nations and more cuts could exacerbate the pressures, which will have a adverse impact on patients, "said Dr. Chaand Nagpaul, president of the British Medical Association.
"Bed occupancy is still higher than the recommended safety levels of 85%, and this adds to the lack of capacity in community services and social care." High levels of bed occupancy can increase the risk of cross infection among patients and make it difficult for many hospitals to provide beds to sick patients who urgently need to be admitted. "
A spokesperson for NHS Improvement, which regulates the hospital's performance, said: "The NHS is under great pressure, bed occupancy is very high in some areas and we owe a huge thank you to your staff for working so hard. hard for patients in these circumstances.
"Planning for this winter has been more effective and more extensive than ever. We would always encourage the public to consider alternatives to go to the hospital whenever possible, including their GP or pharmacist. "