Hospitals are hoping less urgent patients once again stay away as junior doctors in England take part in their second all-out strike later in protest about the imposition of a new contract.
Medics will walk out of both emergency and routine care from 08:00 to 17:00 BST following Tuesday’s stoppage.
Hospitals reported they had coped well during that walkout with some saying they were quieter than normal.
NHS bosses have urged patients to continue to use services “wisely”.
This week’s strikes are the first time doctors have stopped providing emergency care in the history of the NHS.
Emergency protocols have been agreed to allow hospitals to call for junior doctors to return to work if patients are at risk.
But they were not used by any NHS trust on Tuesday, when 78% of junior doctors did not turn up for work.
NHS England’s Anne Rainsberry said that was down to the hard work of staff that were on duty – consultants, middle-grade doctors and nurses were redeployed to emergency services following the cancellation of more than 100,000 routine appointments and nearly 13,000 non-emergency operations.
“This is an unprecedented situation and staff across the NHS have made Herculean efforts to ensure continued safe services for patients.”
She said the walkout continued to bring “heightened risk” which NHS England would “vigilantly monitor”.
“The NHS is open for business but in some places may be under specific pressure. We ask the public to use it wisely in this very challenging time,” she added.
A dedicated webpage has been set up on NHS Choices to provide information about the strike.
A number of hospitals told the BBC that services ran smoothly during Tuesday’s stoppage, with Milton Keynes Hospital saying some actually ran more quickly because of the increased presence of consultants able to make quick decisions.
Dr Cliff Mann, president of the Royal College of Emergency Medicine, said demand at his hospital trust – Taunton and Somerset – had been quieter than normal and he was “absolutely” sure lives had not been put at risk because of the cover provided by other doctors and nurses.
Leeds Teaching Hospital NHS Trust said everything ran “smoothly”, while Doncaster and Bassetlaw Hospitals NHS Foundation Trust said it had not seen “undue pressure”, although it did “anticipate a surge in demand” once the strikes were over.
Frimley Health NHS Foundation Trust in Surrey said: “Contingency plans are going smoothly.”
Health Secretary Jeremy Hunt described the walkout as a “very, very bleak day” for the NHS, but once again stressed the government would not back down, saying no union had the right to stop a government trying to act on a manifesto promise.
BMA leader Dr Mark Porter said he was “pleased” the planning the union had done with NHS England to ensure patient safety had worked well.
But patient groups have warned the accumulation of postponed treatments – nearly 40,000 operations have now been delayed during the whole dispute – is taking its toll and causing harm. Alongside routine treatments, there have been reports of cancer patients facing delays.
The dispute is over a new contract that the government announced in February would be imposed from the summer. This followed the breakdown of talks between the two sides in January.
The contract makes it cheaper to rota doctors on at weekends – something ministers say is needed to improve care on a Saturday and Sunday.
The BMA has argued it is unfair and the NHS needs extra investment to pay for seven-day services.
Before this week’s strikes, there had been four walkouts but all involved emergency care being maintained by junior doctors.
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