Commenting on the four-day junior doctors' strike, which started today, Miriam Deakin, director of policy and strategy at NHS Providers said:

"This week's strike is going to mean disruption on a scale the NHS hasn't seen before from industrial action.

"Keeping patients as safe as possible, trusts' number one priority, will be even harder than in previous strikes so it's all hands on deck. It's not just consultants and specialist doctors stepping into the breach. We're seeing support from GPs, paramedics, pharmacists, community matrons and others playing their part to minimise the risk.

"Getting through today is just the start. Trust leaders are worried about securing adequate cover for the night shifts ahead. This is going to be a very long, difficult week for the NHS.

"We understand the frustration of junior doctors and other staff groups who've seen their pay fall behind inflation year after year and made the difficult decision to strike. But it's exasperating to hear the government and unions talking about why they can't get together rather than just sitting down and talking. We need a leap of imagination from all parties involved in this dispute to end the strikes now.

"While hundreds of thousands of appointments are likely to be rescheduled, there's also the hidden impact of appointments and procedures that were never booked in the run-up to this action. The challenge of bearing down on backlogs – already daunting – just got even harder.

"It's important, too, to remember the wider impact on other areas of the health system, including mental health and community services. Patient care is at risk. We need a rapid resolution to this dispute."