Ahead of the five-day junior doctors' strike starting tomorrow (Saturday) at 7am, Sir Julian Hartley, chief executive at NHS Providers said:

"Every strike sends shockwaves through the NHS, impacting patients and staff with little time to recover in between. Trust leaders have put plans in place to keep patients safe but they are dreading another walkout from junior doctors.

"The scale and duration will have long-lasting ramifications. Over 1.4m hospital, mental health and community appointments and procedures have already been pushed back due to industrial action. No one in pain or distress should have to wait a second longer than they need to given conditions could worsen.

"Trust leaders tell us that this prolonged industrial dispute is rapidly draining staff morale, the lifeblood of the NHS. They are pulling out all the stops to bear down on care backlogs but these walkouts are making this a near-impossible task.

"What's more, strikes have cost the NHS an estimated £3bn so far, piling on financial pressure at a time when trusts can least afford it.

"For the sake of patient safety, we urge that any derogation requests – made by trust-based medical directors, who are senior clinicians acting in good faith – be escalated in a timely way so that trusts can prepare and respond proportionately and effectively to what can be very difficult circumstances.

"It's vital that both sides of the dispute, the government and the unions, now redouble their efforts to find a resolution."