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Professor Sir Stephen Powis said he was “very concerned” about the potential severity of the impact on patients, with hospitals facing nearly 100 hours without up to half their medical workforce.

Up to a quarter of a million appointments and operations could be postponed when doctors in England drop the bitter pay dispute on Tuesday, just after the Easter bank holiday weekend, the NHS Confederation said.

The British Medical Association said industrial action could still be averted if the government made a “credible offer”, but the Department of Health and Social Care (DHSC) has insisted strikes must be called off before negotiations take place.

Professor Sir Stephen said: “This next round of strikes will see unprecedented levels of disruption, and we are very concerned about the potential severity of the impact on patients and services across the country.

“This time, the action immediately follows a four-day bank holiday weekend, which is already difficult as many employees are taking a much-needed vacation, and will be more extensive than ever as hospitals face nearly 100 hours without up to half of the working day. NHS medical staff.

He said the NHS would continue to prioritize emergency, critical and neonatal care, as well as maternity and trauma services, but inevitably hundreds of thousands of appointments, including in cancer care, would have to be postponed again.

Dr Layla McCay, policy director for the NHS Confederation, said the figure could be as high as 250,000 postponed appointments and operations and that health chiefs were more concerned about the impact of this latest strike than any strike so far. amid fears about patient safety. .

She told BBC Radio 4’s Today programme: “In the last young doctors’ strike we saw around 175,000 appointments and operations that had to be postponed.

“In terms of the disruption that we anticipate this time, we estimate that it could reach around a quarter of a million, so it’s a huge impact for patients across the country.”

He added: “What we are hearing from our members who are health leaders across the system is that they are more concerned about this than any other strike.

“They think the impact is going to be so significant that it’s likely to have an impact on patient safety and that’s a huge concern for all healthcare leaders.”

The outage could last up to 10 or 11 days, with a strike between the Easter bank holiday and another weekend, he said.

Health Secretary Steve Barclay has been urged to meet with union representatives in the coming days in an attempt to resolve the issue.

Dr Mike Greenhalgh, deputy co-chair of the BMA’s Young Doctors Committee, told BBC One’s Breakfast programme: “It’s hard to negotiate when only one party is doing it and we’re getting nothing back from the government on that front.”

He added, “We are happy to meet at any time. We would still be meeting him over the bank holiday weekend before next week’s industrial action.

“And if you brought us a credible offer, you could still, even at this late stage, avoid action.”

Dr. Greenhalgh apologized to patients who had operations or appointments canceled and insisted that patient safety would not be jeopardized.

“Patient safety was maintained in the last stoppages, and it will continue to be so in these stoppages,” he said.

The BMA has asked the Ministry of Health to negotiate to resolve 15 years of “salary erosion”, with young doctors losing more than 25% of their salary in real terms.

Dr Greenhalgh said: “At the moment we have over seven million people on waiting lists and the way we do that is by making sure the NHS is adequately funded and staffed.

“And part of that is making sure that there’s a fair deal on our members’ pay.”

BMA workforce leader Dr Latifa Patel said there was a system in place jointly agreed with NHS England to ensure patient safety.

“We met with England’s NHS four times a day during the last few strikes to monitor the situation, but there were no repeal requests, a temporary stoppage of industrial action,” he said.

The four days of strikes will come immediately after the Easter weekend.

They will be from 6:59 am on Tuesday until 6:59 am on Saturday, April 15.