Medical leaders have called for third-party arbitration to break the impasse on a pay dispute between junior doctors and the government after hundreds of thousands of procedures and appointments were cancelled as a result of last week’s strike in England. The “colossal impact” of the four-day stoppage compounded by a health service already stretched by the coronavirus pandemic and facing workplace shortages has led the Academy of Medical Royal Colleges (AoMRC) to intervene and urge both parties to engage with an independent organisation. The AoMRC, the membership body for the UK and Ireland’s 24 medical royal colleges and faculties, said in a statement it was “concerned that a solution has not yet been reached and about the anticipated impact on NHS services and patients that will potentially follow any future action”. It added: “Both parties need to rapidly engage with an independent organisation to work out how the deadlock can be broken for the sake of patients and the wider NHS.” The rare call for intervention came after the junior doctors’ union last week asked the conciliation service Acas to explore ways of breaking the deadlock over their demand for a 35% pay rise. The government has said it will not bring in a “third party” to settle the dispute. In a statement on Thursday, the prime minister’s official spokesperson said the health secretary, Steve Barclay, was ready to speak directly with BMA once strike action was paused. “That is something we had in place for all other talks with unions and has been honoured by other unions. As the health secretary has said before, we need to move away from the starting position of 35%,” the spokesperson said. Dame Helen Stokes-Lampard, chair of the AoMRC, told BBC’s Radio 4 Today programme: “This dispute, which nobody wants – the doctors are suffering too – it needs to be brought to a conclusion and before you can even start to have negotiations you have to have preliminary talks.” It has been seven years since the AoMRC made such interventions to industrial action. “I’m gravely concerned,” said Stokes-Lampard, who is also a frontline practitioner. “All of us are hurting, all of us want a resolution to this, all of us want our NHS in a better place.” The British Medical Association chair, Philip Banfield, said he was “fairly amused” by how the workforce was seen as a cost rather than an investment. “This is a political decision to run the NHS down and the junior doctors sadly have been driven to this point,” Banfield told the BBC, emphasising it was chronic underfunding and running down of the workforce that had led to the service’s longest waiting lists. “There is no number that is set in stone here, it is the principle of restoring pay that has been lost in its value,” he added, referring to demands for a 35% pay rise. Banfield said it was “absolutely bizarre” that in nine months he had not had a face-to-face meeting with Barclay. “I’m afraid his door doesn’t appear to be open.” The NHS’s national medical director, Prof Sir Stephen Powis, said every postponed appointment had an effect on individuals, services and an already exhausted workforce. Nurses, who said strikes could continue until Christmas, are gearing up to stop work again on 30 April and have not ruled out joining forces with junior doctors in future. The president of the Royal College of Emergency Medicine, which represents A&E staff and patients, said recent months had set a trajectory leading to the “medical catastrophe” of a worse winter than that of December 2022. Adrian Boyle, an A&E consultant, told BBC Radio 4’s Today programme: “The vast majority of this is caused by a deeper, underlying problem. We’ve had seven days of junior doctor strikes but these problems have been building up for at least the last five years.” The length of stays in emergency departments was much worse compared with the same period last year, he said, because of full hospitals. Many more people, predominately elderly patients, were spending longer in hospitals, and ambulances were waiting outside emergency departments unable to hand over patients. Hospital capacity needed to be expanded, said Boyle, referring to the need for an increased workforce and more hospital beds. A Department of Health and Social Care spokesperson said: “The health and social care secretary has been clear his door is open and he remains willing to engage constructively, but a 35% pay rise, which would involve some junior doctors receiving £20,000, is unreasonable. Strike action also needs to be paused for formal talks to begin.”