In an open letter, NHS providers, which represents more than 200 healthcare trust in England, deserves the prime minister toe exercise caution when the current tear lists are reviewed next week, the letter says, There are now 10 0 fewer beds in operation, then last year because of coronavirus infection controls, with large numbers of co vid 19 patients needing treatment on top off the usual winter pressures, like flu on all this comes along with the new demand of having to deliver the coronavirus vaccine with more.

Here's our health correspondent Catherine DeCosta.

Yeah, on the front line.

On under pressure, hospitals expect to be at their busiest over winter.

But with the unprecedented impact of coronavirus, this will be a year like no other.

There's no question that were full on during the second wave.

Now on, we're seeing certainly where I work, increasing numbers of covert patients coming in.

We're also dealing with the normal winter pressures, but we're at the same time trying to keep everybody safe and socially distanced while we're dealing with staff who are also unwell.

In a letter to the prime minister, NHS providers say there were 13,000 COV patients in hospital in England this week compared to 500 in early September.

Well, trust me is very concerned.

Its chief executive has urged caution ahead of the review of Tears next week.

What we're saying is you just need to be really careful about relaxing the restrictions on social contact because we know that that inevitably at the moment, what that means is more covert cases, more pressure on the NHS on to be frank, more people dying unnecessarily.

All four nations have bean under tough measures in recent weeks, but the our number which shows whether the epidemic is growing or shrinking, is thought to be above one in some areas.

So it's thought infections arising in London, the southeast and east of England and in Northern Ireland.

And it's a similar picture in Wales to, and that's raising concerns that household mixing and travel over Christmas could lead to a third wave.

Think about what you should do.

Do you really need to have should you really see three different households together indoors over this period.

Can you see fewer people?

Can you see people for a short period of time?

The government says it won't hesitate to take necessary actions to protect local communities.

Its review will be based on the latest data that will include factors such as infection rates among the over sixties and pressure on the NHS.