The instructions from health officials come as hospitals are the most crowded they have ever been in the run-up to winter.

A memo from NHS England and regulators NHS Improvement, seen by the Telegraph, orders hospital trusts to take sweeping measures to bring occupancy down to a recommended safe limit of 85 per cent.

Hospitals have been ordered to “maximise elective activity” in the run-up to Christmas using the independent sector and schemes which pay NHS consultants lucrative overtime rates.

The plans have been drawn up so NHS trusts can cut the number of operations they perform - freeing up more beds for urgent patients - without lengthening waiting lists.

Under such schemes, consultants have been paid rates of up to £1,000 a shift.

But the schemes and heavy use of the private sector is likely to add to financial pressures on the NHS, which last year recorded the highest deficit in its history.

It comes as a separate leaked document shows that GPs are coming under pressure to provide emergency home visits.

Local doctors groups are being asked to establish “A&E Delivery Boards” and to draw up rotas of medics able to respond to 111 requests for urgent care at home, which is currently reserved for those who are housebound.

The boards are ostensibly responsible for easing winter pressures, but the new NHS England best practice guidelines state the measures should remain in place all year round because of the unprecedented demand.

Latest official figures - for the three months ending in September - show NHS trusts have the highest levels of occupancy ever recorded in the run-up to winter with an average of 89.1 per cent of acute and general beds full, compared with 87 per cent in the same period last year.

It follows record levels of bedblocking, with high numbers of patients stuck in hospital for want of care at home.

The memo from health officials, sent to all NHS trust chief executives last month, calls for actions aimed at “lowering acute bed occupancy to 85 per cent from 19 December to 16 January.”