Millions more people in England will be put under the toughest tier four restrictions from tomorrow, Health Secretary Matt Hancock is about to announce.

Ministers were forced to act as hospitals near breaking point across the country, with record numbers of patients and more than 50,000 daily cases yesterday.

Ambulances were queueing outside hospitals in London and Birmingham last night, while ICUs in the capital have asked major hospitals in Yorkshire to take patients in need of intensive care.

Mr Hancock said the number of infections are going up in all regions, not just in London and the South East, where the mutant strain of Covid has spread rapidly.

He said decisions on tiers are not taken lightly, but added: ‘With this new variant growing rapidly – and it’s now the majority of new cases – it is very important that we keep people safe and that we protect the NHS which, as you know, is under significant pressure.’

Saffron Cordery, deputy chief executive of NHS Providers, warned ‘options were narrowing’ and that moving areas into the highest tier was necessary.

‘Pressures on the NHS in some parts of the country are rising at an unsustainable rate,’ she said

‘Thankfully, trusts in other areas have been helping out. But with the virus spreading fast alongside mounting winter pressures, the options are narrowing.

‘We urgently need to get ahead of the outbreak. The Covid-19 tier review offers an opportunity to do that.

‘It will require difficult decisions, moving millions more people to the highest level.

‘The Government must act with boldness, speed and clarity in curbing the threat of Covid-19.’

The latest measures follows the approval of a Covid vaccine from Oxford University and AstraZeneca, with the first jabs expected to be given on Monday.

Mr Hancock said the ‘game-changing’ vaccine could even provide the UK a route out of the pandemic as early as spring.

He hailed the vaccine as a ‘great British success story’ and ‘hundreds of thousands’ of doses would be available next week, including to care homes.

He told Sky News: ‘I am now, with this approval this morning, highly confident that we can get enough vulnerable people vaccinated by the spring that we can now see the route out of this pandemic.’

He said there would be a difficult few weeks ahead but the ‘vaccine provides that route out’ of the pandemic.

‘We have all just got to hold our nerve over the weeks to come.’

Figures from NHS England showed there were 21,787 patients in NHS hospitals in England as of 8am on Tuesday, compared with 20,426 on Monday, and 18,974 at the first wave peak on April 12.

Five of the seven NHS regions in England are currently reporting a record number of Covid-19 hospital patients: Eastern England, London, the Midlands, south-east England and south-west England.

The other two regions, north-east and north-west England, remain below peak levels that were set in mid-November.

Meanwhile the number of further lab-confirmed cases recorded in a single day in the UK hit a new record on Tuesday, rising above 50,000 for the first time, to 53,135.

It is not possible to make direct comparisons with the level of infection during the first wave of the virus, because mass testing was only introduced in the UK in May, but it has been estimated there may have been as many 100,000 cases a day at the peak in late March and early April.

The Government said a further 414 people had died within 28 days of testing positive for Covid-19 as of Tuesday, bringing the UK total to 71,567.

One senior doctor said some trusts in London and the South East are considering the option of setting up tents outside hospitals – something normally reserved for sudden events such as terror attacks or industrial disasters – to triage patients.

The number of Covid-19 patients in London hospitals is now higher than levels recorded at the peak of the first wave of the virus, with 5,371 as of 8am on Tuesday, according to NHS England.

During the first wave, the number of patients in London peaked at 5,201 on April 9.

Dr Susan Hopkins, senior medical adviser for Public Health England, said the ‘unprecedented levels’ of Covid-19 infection across the UK was of ‘extreme concern’.

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