GPS and nurses will be sent to answer 999 calls to prevent long delays for ambulances

the public urged to call 111, use pharmacies and turn to GPS or walk-in centres.

In the North East, GPS and nurses are to be sent out on calls ahead of an ambulance, in a bid to reduce delays.

NHS Clinical Commissioning Groups (CCGS) in County Durham said the scheme was being introduced in response to “huge pressures” on the North East Ambulance Service with many crews left queuing at A&E.

GPS and nurses will be asked to respond to some calls when elderly patients have fallen, and face ambulance delays of an hour or more. An email sent to GP practices last week says the plans aim to ensure pain relief is given more quickly: “We have had some tragic cases where people have been left lying on the floor with a serious fracture and no pain relief,” said the email from NHS Durham Dales, Easington and Sedgefield CCG and NHS North Durham CCG.

Average hospital bed occupancy this winter now stands at 93.8 per cent in England, far above the recommended safe level of 85 per cent, and above the 92.1 per cent recorded last year.

Only seven NHS hospital trusts out of 153 had average bed occupancy below 85 per cent this December. Many said they were under unprecedented pressure, despite the fact most planned surgery is stopped over Christmas.

Dr Chaand Nagpaul, chairman of the British Medical Association, said: “The scenes on the ground are shocking; patients not just receiving care in corridors but unable to get in the door.”

An NHS England spokesman said: “At this time of year, our hospitals, front line and ambulance services are all extremely busy. Thanks to hardworking NHS staff and robust plans to meet with winter pressures, they are generally coping. The public can continue to play their part by seeking advice from 111, NHS Choices, pharmacists, or GP appointments.”