THE NHS is “in bad shape for winter”, experts warn as figures show A&E departments are busier than ever.

The Royal College of Nursing said the health service is “hurtling towards another winter crisis”.

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Hospitals and ambulance services are plunged into difficulty every year and this season is set to bring more of the same.

Medical director of NHS England, Professor Sir Stephen Powis, admitted it will be “incredibly busy”.

Last year, three in 10 casualty visitors waited more than four hours to be seen and a near-record 54,000 languished for 12 hours or more in January.

NHS statistics showed today that 2.21million people went to A&E last month, the highest ever for September.

It follows the busiest summer on record and comes before winter coughs and colds set in.

The NHS is approaching winter in bad shape. Patient care continues to fall short of expectations

Siva AnandacivaThe King’s Fund

Ambulance delays and A&E waits have already begun to get worse, the latest data show.

And stats from the UK Health Security Agency show the number of people admitted to hospital with Covid is increasing, from a rate of 3.72 per 100,000 people last week to 4.55 per 100,000.

Siva Anandaciva, of the King’s Fund think-tank, said: “The NHS is approaching winter in bad shape.

“Industrial action is continuing, financial pressures are rising, and important performance targets continue to be missed. 

“Patient care continues to fall short of expectations.”

‘Trade-offs’ between crisis management and reform

Ministers say they are preparing for winter but Health Secretary Wes Streeting has pledged to stop the health service burning cash to cope with daily demands.

Mr Anandaciva added: “NHS services will have to make harsh trade-offs between immediate winter preparations and longer-term improvement.”

Surgery waiting lists remain stubbornly high, rising to 7.64million in August.

Patricia Marquis, director at the Royal College of Nursing, said: “The NHS appears to be hurtling towards another corridor care crisis this winter. 

“Without intervention, the government’s next 100 days will be defined by patients crammed into fire escapes, store cupboards and corridors.

“The government’s long-term reforms to the NHS are necessary, but patients and nursing staff also need action in the here and now.”

Saffron Cordery, of NHS Providers which represents hospital bosses, said: “The NHS has had its busiest ever summer and is heading for another tough winter.”

Health minister Karin Smyth said: “We have laid out our plans with NHS England to make sure the system is prepared for winter.”

SHUT down rogue butt-lift clinics and only let qualified doctors do them, top surgeons have warned.

The Joint Council of Cosmetic Practitioners issued the plea on Thursday after a 33-year-old Brit mum died in September following a botched BBL.

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Brazilian butt-lifts, also known as buttock augmentation procedures, involve injecting fat or filler into the bum to shape it.

But wrongly injecting too deep into the buttock can pump chemicals into the bloodstream and cause deadly clots, infections or sepsis.

They can also go wrong if the anaesthetic is bungled or people have allergies.

Two people were arrested on suspicion of manslaughter after mum-of-five Alice Webb, from Gloucestershire, died in September following complications of the procedure.

She became the first person to die this way in Britain, although others have suffered fatal ordeals after surgery abroad.

UK regulation is lax as they can be considered “non-surgical” and untrained beauticians can get the kit to do them.

A lack of regulation for unlicensed medical practitioners puts people’s health at serious risk, particularly with buttock fillers

Elaine SassoonThe British Association of Aesthetic Plastic Surgeons

The JCCP said BBLs must be classified as surgical procedures and strictly controlled so that only qualified, registered and experienced plastic surgeons can do them.

The British Association of Aesthetic Plastic Surgeons, which only recently ended a four-year plea for members not to do the procedure at all, co-signed the report.

The Sun has called on ministers to tighten regulation of fillers and cosmetic procedures in our Had Our Fill campaign.

Elaine Sassoon, a member of the BAAPS council, said: “The cosmetic sector faces a lack of regulation for unlicensed medical practitioners.

“This puts people’s health at serious risk, particularly with buttock fillers for BBL. 

“While specialist surgeons follow safety guidelines, untrained individuals can inject unsafe, bulk-purchased products in unregulated settings.”

The report said the same rules should be applied to any procedures on the genitals or breasts.

It said: “These procedures should only be performed by appropriately trained specialist plastic surgeons and fully qualified General Medical Council registered medical doctors who possess additional qualifications and have proven competence.”

Tragic mum told she didn’t need work done

Alice Webb, herself an aesthetic practitioner, had travelled to a training session where she would learn how to perform the procedure before having her own done.

But cops rushed to a house at around 11.30pm that night after the alarm was raised, with ambulances already at the scene.

Alice was taken to Gloucestershire Royal Infirmary but died in the early hours of Tuesday, September 24.

The tragedy happened after her cousin, Dianna Webb, told her she did not need the procedure.

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A tearful Dianna, who calls herself Alice’s “second mum” as she helped raise her, told The Sun: “We had talked about it a lot before she went to have the procedure.

“She had told me she was going to have this done and I said she didn’t need it – she already looked beautiful.

“And she was stunning on her own.

“We were on the phone for two hours before she went. Alice said they seemed really professional and put her at ease about the procedure.

“She was not one of these people that would go and just have something done without looking at every little detail first, obviously because she worked in the industry too.

“Alice put her heart into her work.

“She took every course she could take, including this one, because she wanted to make sure she got everything right.”

Dianna said her family would demand the government ban liquid BBL injections to make sure Alice’s death was “the first and the last” on British shores.

A Department of Health spokesperson said: “Our deepest sympathies are with Alice’s family and friends in this tragic case, which is incredibly concerning.

“The safety of patients is paramount, and we would urge anyone considering a cosmetic procedure to consider the possible health impacts and find a reputable, insured, and qualified practitioner.

“Work is ongoing to explore options around oversight of the non-surgical cosmetics sector and we will provide an update at the earliest opportunity.”