Tens of thousands of patients will have their care cancelled from Wednesday in England amid massive disruption caused by a six-day strike by junior doctors – the longest in the NHS’s 75-year history. Health charities said people whose appointments were postponed – including those with cancer and sight problems – would be left anxious, upset and at risk that their condition could worsen because the stoppage had led to a delay in them receiving help. The Patients Association said patient safety could be compromised because hospitals had too few staff to cope with the industrial action, which begins at 7am. It urged ministers and the British Medical Association (BMA) to bring in mediators to help settle the long-running dispute over junior doctors’ pay after negotiations before Christmas ended in deadlock. “There’s likely to be many, many thousands of appointments cancelled or rescheduled again, and that’s on top of the 1.2m we’ve already seen during well over a year now with periods of industrial action,” said Prof Sir Stephen Powis, NHS England’s national medical director. Powis said that 13 months of strikes by doctors, nurses and other staff was “having an enormous impact on the NHS”. This week’s strike will be the 10th different stoppage by junior doctors since March. By the time it ends next Tuesday they will have refused to work for 34 days in total. Their previous 28 days of action have led to almost 1m outpatient appointments and operations being rescheduled. This week’s walkout threatened to be the most difficult yet for the NHS to cope with because of its unprecedented length and because the BMA chose to stage it during a week in which the service was already “incredibly busy” dealing with a surge in winter illnesses, Powis added. “These strikes are at the very worst time of the year for the NHS.” The Royal National Institute of Blind People voiced concern that many patients “will be coping this week with the distressing news that their appointment has been cancelled or rescheduled or postponed”. Blind and partially sighted people may not even know an appointment had been affected, because the news arrived in a letter rather than by braille or electronic means, added Phil Ambler, the charity’s England country director. The Patients Association said strikes put barriers in the way of patients who already often found accessing care difficult. Julie Thallon, the charity’s acting chair, said: “Patients should have access to safe and effective care when they need it. Strike action imposes barriers to care over and above the long waits many patients are already experiencing. “We are profoundly concerned that the junior doctors’ action could affect the safety of all patients on strike days. Bring in mediators if you need, but please find a way through this impasse.” Sarah Ruane, Macmillan Cancer Support’s director of advocacy, said: “Any uncertainty caused by industrial action is likely to cause real worry and anxiety for people living with cancer who have upcoming appointments or are waiting for results.” The BMA junior doctors’ committee has been seeking a 35% pay rise to act as “full pay restoration” after the real terms value of medics’ pay fell by 26% since 2008-09. Dr Robert Laurenson and Dr Vivek Trevedi, the committee’s co-chairs, urged the health secretary, Victoria Atkins, to make junior doctors the “final” improved pay offer they said she promised last year. Ministers have already imposed an uplift worth an average 8.8% on them for 2023-24 and offered a further 3%. “Instead, doctors are still set to be paid £15.50 an hour and are being forced to go back out on strike by a government that cannot get its act together and make the reasonable offer on pay it knows it eventually must.” They urged Atkins to put forward a “credible offer” that they could put to the BMA’s 46,000 junior doctor members to consider. Matthew Taylor, the chief executive of the NHS Confederation, said hospital bosses had entered 2024 “with a sense of foreboding and trepidation” because of the strikes were coinciding with the NHS being under extra pressure because of winter. Atkins said: “January is typically the busiest time of the year for the NHS and these strikes will have a serious impact on patients across the country. The NHS has again put in place robust contingency plans to protect patient safety and it is vital anyone who needs medical help continues to come forward.”