The must read stories and analysis from Wednesday

You know what some might say

Is the NHS heading back to the infamously dark days of 1990s? NHS England director for acute care Keith Willett insists the health service was not facing a crisis. But he did suggest the NHS has not been under so much pressure since the 1990s.

Professor Willett told Today on Radio 4: “I have been in the NHS a very long time, many decades now, and I have seen similar pressures. Way back in the nineties we saw them. I have seen difficulties like this in the past.”

He also warned further cancellations to elective operations were “certainly a possibility” and the cold weather forecast for the weekend indicated things would get tougher.

Professor Willett was sent out to face the media following NHS England announcing late on Tuesday an extension on the moratorium on non-urgent hospital operations and other significant measures to deal with “sustained pressure” on the emergency care system.

These include suspending penalties for breaching rules on mixed sex accommodation and an order to defer day case procedures and routine outpatient appointments “where this will release clinical time for non-elective care”.

The moratorium on non-urgent inpatient planned care has been extended from mid January to the end of the month. It is estimated this will result in 50,000 operations being postponed.

A senior NHS source told HSJ trust chiefs expect performance data for Christmas week, to be published on Thursday, to be “dire”.

Another senior provider sector source said it was the “toughest winter in 20 years”. This period last year saw prominent reports of many patients being cared for in corridors for long periods, and very poor performance on the four hour waiting time target.