A UK-based doctor who recently returned from working at Gaza's Al Shifa Hospital insists he saw no signs that the building was a Hamas headquarters, as Israel has claimed.

Dr Abdelkader Hammad, a surgeon at the Royal Liverpool University Hospital, was forced to shelter with other foreign nationals when the conflict began. He had arrived in Gaza days earlier on one of his regular visits to perform kidney transplants. 

In the past few hours, the Israeli military has announced it is carrying out what it calls "precise and targeted operations against Hamas in a specified area in Al Shifa Hospital, based on intelligence information." The Hamas government media office has called the raid a "war crime," a "moral crime" and a "crime against humanity."

Hammad told CGTN: "I've been to the Al Shifa Hospital for over 10 years, over 30 visits. I operate in that hospital for four or five days and I've never seen a military situation in Al Shifa.… I've been to most of the departments in the basement, the radiology department, and so on. I've never seen anything like this."

The surgeon called the situation at Al Shifa "catastrophic" and said he knew of at least four medics at the embattled hospital in Gaza City who have died since he left a few days ago.

He explained: "Since my return I've been in touch with my colleagues there. Unfortunately, one of my colleagues who is a nephrologist, a kidney doctor, was killed by an air strike on Saturday. His name is Hammam Allouh. They told me three nurses have been killed as well."

Before the raid, Israeli forces had surrounded the hospital – the enclave's largest – which they say sits atop an underground headquarters of Hamas militants.

Hamas, Gaza's ruling Islamist group, denies fighters are present and says 650 patients and 5,000-7,000 other displaced civilians are trapped inside the hospital grounds, under constant fire from snipers and drones. It says 40 patients have died in recent days, including three premature babies whose incubators lost power.

Speaking on Tuesday before the Israeli raid, Hammad called the situation at the hospital "grave" and said the doctors feel "helpless" in treating seriously injured patients. He said: "In addition to that, they are in fear for their lives as well, because, as I mentioned, some of them have been hit."

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Palestinians trapped inside Gaza's largest hospital were digging a mass grave on Tuesday to bury patients who died under Israeli encirclement, and said no plan was in place to evacuate babies despite Israel announcing an offer to send portable incubators.

Israel denies the hospital is under siege and says its forces allow exit routes for those inside. Medics and officials inside the hospital deny this and say those trying to leave come under fire.

Hammam asked: "When they are talking about evacuation, where are you going to evacuate these people? The other hospitals are already overwhelmed with the number of patients coming. The talk about evacuation is a smokescreen."

He added: "What we need is to make these hospitals operational again, get fuel so they can get electricity, they can work their incubators, the dialysis machines and so on. That's the only solution. Otherwise, we'll see more and more patients die in Gaza, unfortunately." 

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