A senior Nottinghamshire doctor says the local NHS is in an "extremely worrying" state after it declared a critical incident weeks before the usual winter pressures are expected to reach a peak.

The incident was declared for the entire Nottinghamshire NHS last week, meaning hospitals were unable to cope with the rising numbers of patients coming through their emergency departments.

The incident was stood down on Thursday (October 7) after a reduction in hospital bed admissions and an increase in discharge levels.

A similar incident was also declared in July.

Speaking to the Local Democracy Reporting Service in a personal capacity, Dr Irfan Malik, senior partner at Elmswood Surgery in Sherwood, said: "It's really unfortunate we had this critical incident declared towards the end of September. It's extremely worrying it came so early.

"I wasn't expecting it this soon, it is a surprise it came so early in the autumn.

"I am really worried about this winter because the last few years the NHS crisis has got worse and I think this winter will be worse than the last few we have had."

The Integrated Care Board, which co-ordinates healthcare resources across all NHS hospitals and services, said it continues to see high numbers of patients in emergency departments.

In the last week, local hospital trusts and East Midlands Ambulance Service leaders have spoken out about the pressure the local NHS is under.

Senior staff at the Queen's Medical Centre also apologised to patients who had planned operations cancelled because of the delays.

A fortnight ago, more than 200 patients across the Queen's Medical Centre and City Hospital were at one point deemed 'medically fit for discharge' – but could not leave the hospitals because there is not enough support for them in the social care sector.

Rachel Eddie, Chief Operating Officer at Sherwood Forest Hospitals, also said her trust had 138 patients who were medically fit for discharge at its worst point in this period.

Ms Eddie said extra medical and nursing staff had been put in place as well as extra porters and patient transfer teams to create extra bed space.

Dr Malik added: "There is the ongoing threat of Covid infection and I think we are going to get more viruses like influenza as well.

"All aspects of the NHS are under huge pressure even now, so I am worried about how the system will cope with that demand over winter."

He said he felt the system needs more assistance from the Government, which he said had not yet materialised.

Dr Malik said: "I personally feel it is quite a chaotic situation and our health secretary doesn't have a grasp of the crisis points affecting our NHS.

"We get stuck in the middle because many of our patients are waiting over a year for outpatient appointments and waiting a long time for operations.

"When there is a critical incident and operations are cancelled, that just means increased people on a longer waiting list and they keep on coming back to us to get seen sooner.

"We are stuck because we can't help them in that situation. We try but because of the backlogs in the hospital, it leaves us in a difficult situation."

Amanda Sullivan, Chief Executive of NHS Nottingham and Nottinghamshire said there are "robust plans" heading into winter.

She said: "The system is putting a number of extra measures in place to help alleviate some of the expected pressures.

"These include setting up virtual wards – designed to support patients who would otherwise be in hospital, to receive the care, monitoring and support they need in the place they call home.

"This helps to prevent avoidable admissions into hospital and supports early discharge out of hospital. We are also working with colleagues across the system to ensure they are working with families of patients to make them aware of the benefits of recovering at home once they are well enough to leave hospital."

She said even though the critical incident has ended, patients are advised to contact 111 if they are unsure where to go.

Last month health secretary Thérèse Coffey set out the government's plan for patients, outlining that the NHS will open up the equivalent of 7,000 beds so that "every hospital has space to see and treat patients more quickly".

The Department for Health and Social Care added: "Ahead of this winter, we will launch the next phase of our national recruitment campaign to encourage more people to join social care. DWP (Department for Work and Pensions) will help to promote careers in adult social care to job seekers, with improved resources for Jobcentre Plus work coaches.

"We are developing the knowledge and skills framework, career pathways and ongoing investment in learning and development to support progression for care workers and registered managers.

"We will invest £15 million to help boost international recruitment of care workers."