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Health leaders have urged ministers to “pull every lever” to prevent any further strikes, warning that NHS England cannot afford more industrial action as the service braces for one of its most testing winters.

The warning by NHS Providers, which represents health organisations across England, came as talks continued between the government and the British Medical Association doctors’ union to resolve its fractious longstanding pay dispute.

Strikes across the health service since December 2022 have compounded the pressures faced by NHS England ahead of winter, with about 1.2mn operations and appointments already cancelled since walkouts began.

“The NHS can’t afford further strikes,” warned Sir Julian Hartley, chief executive of NHS Providers, adding that further action will jeopardise UK Prime Minister Rishi Sunak’s pledge to cut record waiting lists by the next general election.

“Talks between the government and doctors’ union are promising and it’s absolutely vital that ministers pull every lever they can to break the deadlock,” he said.

Consultants and junior doctors represented by the BMA have called on the government to improve its pay offer to all doctors, while the two sides are locked in talks as they attempt to break the deadlock.

One person with knowledge of the talks said they had so far been “cordial” and were “progressing” but the two sides still “remain quite far apart”. 

Nurses and other health staff including ambulance workers, nurses, physiotherapists and porters settled their pay disputes in May after unions backed a deal.

Ministers have said the advice of the independent pay review body, which makes recommendations to the government on the salary of NHS staff, is final. This includes a 6 per cent annual pay rise plus a payment of £1,250 consolidated into base pay for junior doctors.

On Monday, Victoria Atkins, former financial secretary to the Treasury, was appointed health secretary, replacing Steve Barclay in a cabinet reshuffle.

Sunak’s five policy pledges outlined in January included cutting NHS waiting lists ahead of the next election. Recent data from NHS England revealed patients were waiting for a record 7.8mn appointments in September.

“There could well be more strikes and if there are I think that really will put paid to the delivery of that pledge,” Hartley said. “I do think there’s a sense of dread of strike action being revived as we head into this winter period.”

A survey of health trust leaders by NHS Providers published on Tuesday found that 95 per cent were “concerned about the impact of winter pressures”, with 80 per cent predicting this season “will be tougher” than the last.

More than 80 per cent of trust leaders “strongly agreed” that “continued industrial action over 2023-24 will compromise the NHS’s ability to deliver national recovery targets for elective and urgent and emergency care”.

Less than half of those surveyed believed the quality of care provided by the health service was “high”, while 30 per cent said they would be able to give “high” quality care to patients over the next two years.

NHS England said: “Disruption due to strike action has had a significant impact on patients and staff, and created unavoidable financial costs,” adding that “the primary focus for routine activity [this winter] should be on long waits as well as urgent elective and cancer care”.

The Department of Health and Social Care said it recognised the challenges faced by the NHS, and that it had started preparing for the season “earlier than ever before”.

“We have already invested billions to improve performance along with an additional £800mn for this winter to support urgent and emergency and maternity and neonatal care, tackle the longest waits and cancer backlogs, and boost discharge rates.”

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