Junior doctors on Wednesday began the longest strike in NHS history as figures revealed that more than 337,000 appointments and operations had been cancelled in London due to industrial action.
NHS leaders warned that the health service was facing its "toughest challenge yet" as thousands of medics in the British Medical Association began a six-day walkout over pay at 7am.
The strike will affect almost all routine services as the NHS shifts its focus to urgent and emergency care. Hospitals are also grappling with a surge in flu, norovirus and Covid cases.
The strike will end at 7am on January 9.
It comes after talks between Health Secretary Victoria Atkins and the BMA broke down last month, with the Government insisting that negotiations could not resume unless the union called off strike action.
Analysis by the Standard found that more than 337,000 inpatient and outpatient appointments had been rescheduled in London across a year of industrial action in the NHS.
It is by far the highest figure of any region in England and accounts for more than a quarter (27.8 per cent) of the 1.2 million operations and procedures cancelled nationally.
An NHS source said that the high rate of cancellations in London could reflect how a higher proportion of doctors in the capital were on strike compared with other regions.
Patients have been advised to call 999 in a life-threatening emergency, but everyone else should use 111.
Age UK has warned that the threat of strikes could deter elderly people from seeking care when they need it.
The charity also said it will be “difficult to guarantee safe and effective care for everyone who needs it”.
The latest figures show that a total of 1,181,990 Londoners were waiting for NHS treatment at the end of October, including more than 68,000 children.
Barking, Havering and Redbridge University Hospitals NHS Trust said it had rearranged 1,373 outpatient appointments and 88 non-urgent surgeries ahead of the latest round of action. Patients attending A&E without an emergency condition were warned of “very long waits”.
David Probert, chief executive of University College London Hospitals, said the “vast majority” of routine appointments at his trust would be cancelled.
Sir Julian Hartley, chief executive of NHS Providers, said that the junior doctors’ strike was going to be “incredibly tough” for the NHS.
He told BBC Breakfast: “There is going to be a significant impact on patients. Most planned operations and appointments will have to be stood down.
“There is a lot of Covid and flu about and that can affect staff as well as patients, so the challenge of filling those rotas will be significant for a lot of organisations.”
The BMA is seeking a 35 per cent pay rise to correct a real-terms fall in income since 2008, but ministers have branded the demand “unaffordable”.
Dr Robert Laurenson and Dr Vivek Trivedi, co-chairmen of the BMA junior doctors committee, said: “This strike marks another unhappy record for the NHS – the longest single walkout in its history – but there is no need for any records to fall: we can call off this strike now if we get an offer from Government that we can put to members.”
Ms Atkins said the strikes would have a “serious impact” on patients and urged the BMA to call off the strikes and return to negotiations.
In summer 2023, the Government gave junior doctors in England an average rise of 8.8%, but medics said the increase was not enough and ramped up strike efforts.
Late last year the Government and junior doctors entered talks with a view to breaking the deadlock, but after five weeks of negotiations the talks broke down and medics called more strikes.
