Responding to news that junior doctors in England plan more strikes in December and January, Sir Julian Hartley, chief executive of NHS Providers, said:

"This is the outcome that trust leaders were dreading.

"This will be the longest strike in NHS history during the busiest and toughest time of the year for the NHS.

"These strikes will undermine efforts to cut waiting lists further, they'll have a serious knock-on effect on services right across the NHS and they'll impact the quality of care for patients.

"The planning starts now to minimise the impact of this industrial action and safety will be the overarching priority. But, as we have seen with previous walkouts, patients will once again pay the price through renewed delays and disruption.

"We know this walk out will be especially hard for trusts to manage given lots of staff will have annual leave booked over the festive period.

"Strikes have cost the NHS more than £1.3bn already and more than one million delayed patient appointments. The strikes announced today will only add to the toll.

"It isn't too late for the government and unions to sort out this dispute and to prevent more strikes. Trust leaders hope the walkouts will be avoided."