NHS bosses have urged the health secretary to let the arbitration service Acas see if it can help to break the deadlock in his deepening dispute with junior doctors in England who are striking over pay. The NHS Confederation has written to Steve Barclay and the British Medical Association (BMA), the main doctors’ union, asking them to accept the Advisory, Conciliation and Arbitration Service as an honest broker that could set up talks to end the row. It emerged on Wednesday that the BMA had begun talking to Acas to explore the possibility of it ending the impasse. The confederation’s initiative and the union’s decision to talk to Acas has put pressure on Barclay to agree. It is unclear if he will do so, however, and the Department of Health and Social Care did not immediately reply to questions. The confederation represents the 220 NHS trusts in England and the health service chiefs that run them. It has estimated that this week’s four-day strike by junior or trainee medics will lead to as many as 350,000 appointments and operations being rescheduled. Barclay has called the BMA’s demand for a 35% pay rise for England’s 61,000 junior doctors unreasonable, but he did not respond last week when their leaders signalled their readiness to compromise on the figure by asking him to put forward a credible offer as the basis for negotiations to begin and the 96-hour walkout to be called off. The NHS Confederation’s chief executive, Matthew Taylor, told Barclay and the BMA in his letter that health service bosses were worried that the dispute would significantly harm the NHS unless the two sides agreed to engage in meaningful discussions. “While we await what we hope is inevitable eventual negotiation, our members are questioning how much damage will be caused along the way,” he wrote. “Health leaders want both sides to do everything within their power to find some common ground as soon as possible, and it seems that the current approach is not working here.” There are no talks ongoing, only increasing public hostility between the sides. In reference to that, Taylor wrote: “Therefore we are now urging you both to invite Acas, the Advisory, Conciliation and Arbitration Service – or another mediation service – to support with negotiations and help to bring this industrial action to a close. “With both sides having seemingly incompatible preconditions for negotiation, we believe this option should be explored as a matter of urgency to help bring both sides to the table and find a way forward.” The BMA’s leader, Prof Philip Banfield, said that because “the government consistently refuses offers to meet and puts up obstacles to prevent any meaningful talks occurring”, he hoped ministers would drop their preconditions and agree to Acas playing a role. Despite the BMA’s willingness to compromise, Barclay claims it is insisting on its 35% claim as a precondition for talks to occur. Banfield denied that and accused him of being “seemingly intransigent and inflexible to all our attempts to reach a settlement”.