Hospital bosses are concerned about maintaining overnight care for patients during the junior doctors strike this week due to a shortage of consultants.
NHS Providers, which represents NHS trusts, said the health service faces a “long, difficult week” as bosses attempt to fill vacant posts created by the strike.
Londoners were on Tuesday issued with the starkest warning yet over the junior doctors’ strike as NHS bosses pleaded with the public to stay away from A&E unless they have a life-threatening condition.
NHS managers have warned that patient care is “on a knife-edge” due to the walkout by members of the British Medical Association (BMA), which will last until Saturday morning. The union is seeking a pay rise of 35 per cent to restore a real-terms fall in income since 2008.
Up to 5,700 junior doctors in London began the most disruptive strike in NHS history at 7am on Tuesday over pay, with more than 50,000 appointments and procedures set to be cancelled in the capital during four days of action.
Miriam Deakin, director of policy and strategy at NHS Providers, said that overnight care posed a particular problem for many hospitals struggling to provide adequate staffing levels.
“Getting through today is just the start. Trust leaders are worried about securing adequate cover for the night shifts ahead. This is going to be a very long, difficult week for the NHS.
“We understand the frustration of junior doctors and other staff groups who’ve seen their pay fall behind inflation year after year and made the difficult decision to strike. But it’s exasperating to hear the government and unions talking about why they can't get together rather than just sitting down and talking.”
Professor Sir Stephen Powis, national medical director for the NHS in England, told BBC Radio 4's Today programme that the strike would cause “unparalleled disruption” and that cover for striking doctors was "very fragile".
“We will endeavour to keep patients safe, particularly in those emergency services, but that is becoming harder every time we have this strike action.”
Dr Chris Streather, Medical Director for the NHS in London, warned Londoners to “use the NHS wisely” during the strikes.
He told the Standard: “This strike will be more disruptive than any we’ve seen before. People who are really sick should not hesitate to seek emergency treatment, but we would prefer if those with a minor condition go to a pharmacy or call NHS 111.”
Medical staff in the capital would be “spread more thinly”, he said, meaning that NHS trusts “cannot eliminate risk” to patients.
He added: “The important thing is for patients waiting for critical surgery, such as cardiac or cancer, to report any change in symptoms to 111 or their GP. We will handle those situations as an emergency without hesitation.”
Ministers escalated a war of words with the BMA on Tuesday as Downing Street branded the strike “extremely disappointing”.
A No 10 spokesman said the union’s pay demand “completely out of step with pay settlements in other parts of the public sector” and claimed it would cost £2 billion.
But Dr Emma Runswick, deputy chairwoman of the BMA Council, said the union had heard “absolutely nothing” from Mr Barclay regarding pay negotiations.
She told BBC Breakfast: “None of us want to be on strike here… we’re looking for the Government to move but we will continue, our mandate is incredibly strong.”
Dr Vivek Trivedi, co-chairman of the BMA’s junior doctors committee, said: “The Government has not even tried to meet us anywhere in the middle, it hasn’t given us a counter-offer at all.”
NHS leaders have urged the Government and the BMA to call in the Acas conciliation service to resolve the deadlock. BMA sources told the Guardian that walkouts could continue until next year, threatening Prime Minister Rishi Sunak’s pledge to cut waiting lists for treatment in the next eighteen months.
Dr Simon Steddon, Chief Medical Officer at Guy’s and St Thomas’ NHS Trust, said he was “very concerned” about the “potential harm” that may be caused to patients by the strike.
“Many people whose appointments or procedures are being cancelled will now have experienced this on multiple occasions, which is incredibly distressing for our patients, and their friends and families. We will do everything in our power to maintain patient safety but the impact of these strikes on patient care will be extensive and on a scale we’ve not seen before.”
Matthew Trainer, chief executive of Barking, Havering and Redbridge University Hospitals NHS Trust, said he could “not afford to keep cancelling appointments every month” and that the NHS was “moving backwards” while strikes continue.
“For a second month running, we have had to cancel outpatient appointments, diagnostic tests and operations because of strike action. This has affected thousands of patients.
“I would like to apologise to them and to those who will wait longer in future because we need to rebook these delayed appointments.
“I fully understand why our doctors are taking industrial action and I support their right to strike. They are struggling with the impact of student debt, rising costs of living and a big drop in pay, in real terms. We are not doing enough to encourage doctors in training to stay in the NHS.”
He added: “We cannot afford to keep cancelling appointments every month. We have worked incredibly hard to reduce to zero, by the end of March, the number of people waiting more than 18 months for their treatment. This is a brilliant achievement by our Trust.
“Every time there is industrial action, we run the risk of moving backwards. We need to see proper negotiations between the government and unions on junior doctor pay and a suspension of strike action.”
Whittington Health NHS Trust, which runs the Whittington Hospital in Archway, said it had made the “difficult decision” to reschedule all non-emergency procedures and outpatient appointments to ensure enough staff are available to provide emergency care.
Meanwhile, a new poll released by Ipsos found that more than half (54 per cent) of Britons supported junior doctors taking strike action, while a quarter (24 per cent) were opposed.
Ambulance workers, nurses and physiotherapists are currently voting on whether to accept an offer made by the Government in a separate pay dispute.
