As I walk through the doors of ward 23, I am struck by a sense of deja vu.
Bay after bay, bed after bed, is full of sick, sometimes very sick, patients.
They are mostly elderly and look frail. Most have flu, some have COVID, and others have respiratory infections.
The really unlucky ones have a combination of two or more of these viruses. The scene brings back memories of my visits to hospitals full of COVID patients at the height of the pandemic.
One of the ward's 23 patients is John Greenwood. He's 92 years old. He lives alone. His wife is in a nursing home.
John woke in the early hours of Sunday morning, barely able to move. He had been struck down by flu.
John's son rushed him to The Royal Preston Hospital. They could not risk waiting two hours for an ambulance.
"When I was young, the way people talked, I just thought people would get healthier and healthier and hospitals won't be required as much," John tells me from his hospital bed.
"And it's just gone the opposite."
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'I've never seen anything like this'
John has made good progress in his recovery, but is clearly still not fully over his infection.
"When I came in I couldn't take a drink, I couldn't do anything, and I'm getting slightly stronger every day," he says.
"I couldn't even use my mobile phone. I still feel very weak.
"I've had to have a bed bath this morning, they said 'can you do it yourself?'"
The ward is operating at 100% capacity, and it has been for some time.
As soon as a bed is vacant, it is filled again with a waiting patient. The pressure is relentless.
Professor Mohammed Munavvar says he has never seen a winter like it.
"I have been here as a respiratory consultant on this ward on this hospital for 24 years, and I've never, ever seen anything like this before," he says.
One of the worst winters ever for the NHS
Professor Munavvar is one of northwest England's most senior respiratory consultants.
His expertise helped this hospital to navigate through the peak of the pandemic. His skill is being tested again as the NHS buckles under one of the worst winters ever.
But this winter, he says, is the worst he's ever seen.
"You've got a COVID bay, you've got influenza patients, you've got COVID again after that," he says, and worries that this pressure will impact hospital waiting lists.
"If we focus our time and efforts on our acute hospital then we have less time to do our other jobs, which are seeing patients in the clinics, doing procedures and endoscopy units in theatres," he says.
"So already with the two-three year backlog that has developed thanks to COVID, we were trying to play catch-up, we were trying to clear some of that backlog, now this will set us back again."
Strikes bringing even more woe
And this is why the small positive from this month's NHS performance figures, of the elective waiting list for England falling from 7.21 million to 7.19 million, is unlikely to be repeated next month.
The data represents November last year, ahead of the flu season and before the industrial action by health workers.
More dates are set to be announced by ambulance workers, and the British Medical Association, the doctors' union, is balloting its members on strike action.
Ambulance response times and waking times for treating continue to climb. This is because of rising demand and the inability of ambulances to discharge their patients because there is little or no capacity inside the hospital.
This is largely due to the delayed discharge of patients who have no social care package in place.
The government's plan to buy up care home beds has been criticised by some health leaders as too little too late.
In the short term at least, it is hoped it will create some capacity to ease the pressure.
There are also indications that COVID and flu infections are beginning to fall.
This has happened for two consecutive weeks now, so earlier fears that the figures might not give the true picture because of the Christmas holidays might be unfounded. Still, it is too early to say for sure.
Ward 23 is full and likely to remain so for a number of weeks to come.