Responding to Royal College of Nursing's announcement of 48-hour strikes in March which include staff from A&E, intensive care and cancer wards, Sir Julian Hartley, chief executive at NHS Providers said:

"This is the most worrying escalation of strikes yet. With more than 140,000 appointments already postponed as a result of the walkouts, this is a step no one wants to take.

"A continuous 48-hour strike with no exceptions in A&E, intensive care units or cancer care services will be a huge blow – especially as even more trusts will be affected this time. 

"With further strikes by ambulance workers planned in the coming days and weeks, and junior doctors' walkouts also likely, trust leaders are now in a near-impossible position. They're deeply concerned the escalation could hamper their efforts to tackle care backlogs and compromise continuity of care for some.

"Without a resolution, this ongoing dispute could lead to serious, long-term damage to the NHS. We understand that frontline staff feel they've had no choice but to take this action due to challenges including the high cost of living, workforce shortages and below-inflation pay rises.  

"Trust leaders will be working flat out to ensure patient safety and provision of vital services, but they can only do so much by themselves. The government needs to talk to the unions urgently about pay for this financial year."