The Royal College of Physicians (RCP), which carried out the study, said the results exposed a health system “pushed to its limit” in which doctors felt they could not deliver what was asked of them.

One told researchers: “We are not robots, we are human beings with limits.” Another said: “I cried on my drive home because I am so frustrated and distraught at the substandard care we are delivering.”

According to the study, 80% of those asked said they were worried about the ability of their service to deliver safe patient care in the next 12 months and 84% believed the workforce was demoralised by the increasing pressures on the NHS.

By all but one measure, doctors said conditions were worse than last year. In positive news, there was a reduction in the number of doctors experiencing delays in patients being transferred from their care.

“It is extremely worrying and depressing that our doctors have experienced an even worse winter than last year, particularly when so much effort was put into forward planning and cancelling elective procedures to enable us to cope better,” said the RCP’s president, Prof Jane Dacre.

“We simply cannot go through this again. It is not as if the situation was either new or unexpected. As the NHS reaches 70, our patients deserve better. Somehow, we need to move faster towards a better resourced, adequately staffed NHS during 2018 or it will happen again.”

The RCP proposed relaxing visa restrictions for health workers, making more money available to match growing patient need, including in social care, and more investment in public health initiatives that reduce demand.

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