The latest round of junior doctors' strikes could lead to more than 75,000 operations and appointments being cancelled in London, analysis shows, as medics walked out for a second day.
The 72-hour England-wide walkout, which began at 7am on December 20 and will run until the same time on Saturday, comes as the NHS grapples with one of its toughest winters on record.
The British Medical Association (BMA) announced the strike earlier this month after talks between junior doctors and the Government broke down. It will be followed by a six-day walkout from January 3, the longest in NHS history.
NHS bosses in London warned on Wednesday that services were under "extraordinary pressure" due to a "high volume of sick people" and that the strike had come "at the worst possible time".
Analysis of NHS figures suggests that the health service has cancelled an average of 35,500 appointments during each of the previous 25 days of industrial action.
If this continues at the same rate for another nine days, it means that a further 320,000 patients could have planned surgery or appointments postponed over the course of December and January's strike action.
In London, an average of 8,444 operations and appointments were cancelled during the period, meaning that as many as 75,900 could be axed in the capital.
The number is likely to be far higher as many NHS trusts now do not book any patients in on strike days, to save having to reschedule them.
Barking, Havering and Redbridge NHS Trust, in east London, said it had rearranged 860 outpatient appointments and 78 non-urgent surgeries in anticipation of the strike. Anyone not needing emergency care would face a "long wait" in A&E, the Trust said.
Health Secretary Victoria Atkins on Thursday defended the Government's position that negotiations would not be reopened unless the strikes were called off.
She told Sky News that NHS England “is a little bit like an oil tanker” because it takes time to prepare for the disruption caused by industrial action.
“The moment that a strike is called, that has very, very serious consequences for the whole of the system,” she said.
“So for the last week-and-a-half, managers, medical directors, clinicians up and down the country, have been devoting days and days of preparation to trying to keep the system stable during these strikes.
“We have to have certainty from the junior doctors’ committee, whereby they call off the strikes and then we can go into negotiation.
“I cannot flick NHS England on and off like a switch.”
The BMA’s junior doctors committee has challenged the Government to make an offer so strikes could be cancelled.
It said the offer from the Government, an average 3 per cent rise from January – on top of the average of nearly 9 per cent recommended by the independent pay review body in April, was not enough to make up for below-inflation pay rises since 2008.
It has asked for a full pay restoration that the Government said would amount to a 35 per cent pay rise – which ministers have said is unaffordable.
Conciliation service Acas said it is “ready to help” resolve the dispute.
The NHS has said emergency and urgent care will be prioritised during the strikes and that “almost all” routine care will be affected.
Hospital leaders have described the walkouts as their “worst fears realised” as they grapple with a rising number of people needing help with winter viruses, particularly norovirus.
Junior doctors in Wales are planning a 72-hour walkout from January 15, while doctors in training in Northern Ireland are being balloted for potential strike action.
Junior doctors in Scotland have already come to an agreement with the Scottish Government.
Consultant doctors from the BMA in England have reached a deal with the Government, with members currently voting whether or not to accept the deal.
Specialist, associate specialist and specialty doctors (SAS) in England have also come to an agreement, which is being put to members.
Elsewhere, Ms Atkins has written to the bodies which recommend salary uplifts for NHS staff to ask them to begin looking at the pay round for 2024/25.
