The survey of the most senior executives running hospitals, ambulance services, mental health providers, community services, primary care and integrated care systems comes hours before new performance figures for the NHS in England are due to be published.

The number of people waiting for hospital treatment in England has hit a record high of 5.7 million as the NHS struggles to clear the backlog of care that has been worsened by the pandemic. Updated figures are expected on Thursday.

The greatest areas of concern for NHS leaders are primary care, and urgent and emergency care, according to the survey.

Matthew Taylor, the chief executive of the NHS Confederation, said: “Almost every healthcare leader we’ve spoken to is warning that the NHS is under unsustainable pressure, and they are worried the situation will worsen, as we head into deep midwinter, unless action is taken. They are also sounding alarm bells over risks to patient safety if their services become overwhelmed, on top of a severe workforce crisis.

“The health and social care secretary says the NHS is not under unsustainable pressure, but NHS leaders are clear that we have reached a tipping point. Frontline providers across all parts of the NHS are under intolerable pressure.”

Before pubs opened for the first time since 23 March, NHS England told hospitals and ambulance services that demand for care was likely to match that of New Year’s Eve. Police forces deployed extra patrols.

Early indications, however, were that criminality and the number of A&E admissions as a result of alcohol were not as high as many had anticipated, although there were small pockets of disorder.

John Apter, the chair of the Police Federation, was on shift in Southampton where he said he dealt with “naked men, happy drunks, angry drunks, fights and more angry drunks”.

He said:“What was crystal clear is that drunk people can’t/won’t socially distance. It was a busy night but the shift managed to cope. I know other areas have had issues with officers being assaulted.”

Images from Soho, central London, showed packed streets into the early hours of Sunday.