More private ambulances on the road, nearly 2,000 extra doctors' appointments, and measures to get patients out of hospital quicker.

Those are just three of the initiatives launched in Norfolk and Waveney's NHS winter plan, in a bid to avoid - as much as possible - the crisis seen in the health service last winter.

Ambulances queued outside accident and emergency departments and hospitals at bursting point became regular sights last year, as staff tried their hardest to battle into work against the Beast from the East.

But Mark Burgis, running Norfolk's winter health operation, said although demand would again be high, there were more plans in place this year.

He said: 'This year we expect pressures over the winter to be just as great as ever. So we have planned well ahead with more services, more capacity and more support for local people and patients.'

A new discharge suite at the Norfolk and Norwich University Hospital (NNUH) is under construction, where patients ready to leave could be moved to, to free up beds earlier in the day.

Plus the discharge lounge at the Queen Elizabeth Hospital (QEH), in King's Lynn, has been expanded and enhanced.

Six more ambulance rapid response vehicles have been put on to the road, and ambulance trust interim chief executive Dorothy Hosein said money had been put towards additional shifts that staff could sign up for if they wanted to, to get more ambulances on the road - and already those extra shifts have increased cover by 20pc.

And she said they planned to use more private ambulances this year too. She said: 'When you look at the private vehicles that we had secured last year to help us support our vehicles there were about 15 to 16 per day, we're talking about 45 day now.'

The use of private ambulances has previously been controversial because of their high cost, however patients last year reported long waits for ambulances when fewer were used.

At the NNUH there are also 57 additional beds, and eight new rapid assessments spaces in A&E - plus a new home ward service to care for up to 30 people at home who do not need to be in hospital.