More than 1m outpatient appointments and operations have been cancelled since strikes began in December across the NHS in England, figures reveal. Last week’s four-day stoppage by consultants and junior doctors forced hospitals to reschedule 129,913 more “episodes of care”, taking the total to just over 1m, NHS England said. Those postponements mean that in all 1,015,067 have had to be rescheduled. Dr Vin Diwakar, the NHS national medical director for secondary care and transformation, said: “These figures reveal just part of the relentless impact of strikes over the last 10 months with the number of appointments rescheduled hitting more than 1m, with pressure on services increasing as junior doctors and consultants took joint action last week for the first time in the history of the NHS. “We know that each appointment rescheduled is incredibly difficult for patients and families, and as we prepare for further joint action next week, there is precious little time for staff and services to recover.” Confirmation that more than 1m episodes of care have been postponed comes amid growing concern among NHS bosses about rising anxiety and upset among patients whose care is disrupted. Rory Deighton, the director of the acute network at the NHS Confederation, said the figures constituted “a grim milestone”. “The recent wave of coordinated industrial action by consultants and junior doctors has put health leaders and their teams’ backs against the wall in trying to minimise disruption, with cancelled appointments reaching the grim milestone of 1m as a result of walkouts,” Deighton said. “We knew that this first ever joint strike action would create a high risk to patients as well as a higher number of appointments and operations being cancelled. The figures prove the effect it is having on public health.” The true number of scrapped appointments could be up to double the official tally, he added, because hospitals were now not booking appointments for strike days, so they did not have to postpone and rearrange them. Steve Barclay, the health secretary, used the same words to describe the 1m figure – “a grim milestone”. He accused the British Medical Association, the main doctors union, of pushing ahead with “coordinated and calculated industrial action ... creating further disruption and misery for patients and NHS colleagues”. NHS Providers, which represents health service trusts, said on Monday it was not just patients faced with rescheduled appointments but also their families who were ending up in “distress” as a result. Saffron Cordery, its deputy chief executive, said the fact that more than 1 million affected patients had had their care delayed should be reason enough for the strikes to end. “Trust leaders understand only too well the distress this can bring them and their loved ones,” she said. “Behind every delay there is a real and human cost. How many more reasons are needed for an end to the dispute.” Last Friday Lance McCarthy, the chief executive of the Princess Alexandra NHS trust in Harlow, Essex, told his local NHS integrated care board that the strikes had in recent months begun to prove very damaging for staff, patients and the NHS overall. “We are seeing increasing frustration [from] our colleagues around it, because we are constantly duplicating work, cancelling patients, rebooking the same patients etc.” But, he added, in comments reported by the Health Service Journal: “We are [also] quite understandably starting to see in the last two months a really significant increase in anxiety and concern and frustration from our patients, who took it quite well the first couple of rounds but are understandably really frustrated. It is having a really significant impact.” The health secretary announced last week that the government was considering introducing legal “minimum service levels” that would force some doctors and nurses to work as normal, providing care on strike days. About 36,000 cancer appointments have been postponed since December because of industrial action, according to NHS figures that Labour disclosed recently. Another chief executive – the Barking, Havering and Redbridge boss, Matthew Trainer – last week used X, formerly known as Twitter, to make clear his view that: “We need doctors and all our colleagues to feel valued – paid appropriately, with decent working conditions. We need proper pay negotiations ahead of winter.”