The NHS “doesn’t just belong to the junior doctors’ committee”, the Health Secretary has said after a row erupted over pleas for striking medics to return to wards.
A number of hospitals have asked the British Medical Association for local exemptions, known as derogations, amid serious concerns about patient safety.
But the union accused NHS trusts of “undermining the derogation process” by failing to provide evidence they had exhausted all other options.
It is understood to have rejected the majority of requests since the six-day walk-out began on Tuesday.
Victoria Atkins and the Prime Minister both backed local health leaders on Thursday.
The Health Secretary said: “It is absolutely for NHS leaders to decide which services need to be protected.
“I trust their medical judgement, their clinical judgement, with these mitigations that they’re seeking.”
Mr Sunak said the strikes were “disrupting people’s lives”, adding: “They are causing an enormous amount of concern to people.
“It’s absolutely right that NHS leaders, completely independent of Government, are making clinical decisions on the ground and requesting that extra support where they feel that they need it. Of course they have my backing in doing that.”
The longest strike in NHS history is taking place during one of the busiest weeks of the year, as hospital admissions for flu and Covid reach their highest level yet this winter and patients who delayed seeking help over Christmas come forward.
Several hospitals have urged people to only come to A&E in serious or life-threatening cases due to high demand. At least two declared critical incidents on Tuesday.
Speaking during a visit to London Ambulance Service, Ms Atkins said could resume talks with junior doctors “within 20 minutes” if strikes were called off.
“These strikes are very, very serious for our NHS,” she added.
“I’ve said throughout this that, please, to the junior doctors’ committee, the moment you call off the strikes, I’ll get back around the table with you within 20 minutes.
“It’s just we have to have the strikes called off, because the NHS belongs to us all.
“It doesn’t just belong to the junior doctors’ committee, and for the 1.3 million people who work in the NHS, as well of course for the tens of millions of people it looks after, the NHS cannot be switched on and off on whim.”
In a letter to the BMA, NHS England said the union’s decision to question the integrity of local leaders was “regrettable”.
It added: “There is significant concern across the NHS about the impact on patient safety of this period of industrial action.
“It is the longest period of action the NHS has ever dealt with, and has been timed to coincide with the period in which seasonal demand for NHS care typically peaks, and in which staff illness tends to be at its highest due to the circulation of flu, Covid and other winter illnesses.”
The letter also raised concerns about the ability of services to manage patients needing time-sensitive treatment, such as cancer patients or women needing urgent caesarean sections.
Meanwhile, leading medics warned patients could face “significant harm and trauma” in the coming weeks due to a perfect storm of winter pressures.
Writing in The BMJ, immediate past president of the Society for Acute Medicine Dr Tim Cooksley said long queues of ambulances outside hospitals and increasing cases of patients treated in corridors were “inevitable” at this time of year.
He wrote: “Each winter in the past decade has become slightly worse and that trend, which has not been reversed, has resulted in a dire situation which may not yet have reached its peak.
“Too many deeply unacceptable occurrences are now perceived as ‘business as usual’ – corridor care, high vacancy rates and poor levels of staffing, long waiting lists and, more recently, industrial action
“All need focus, although arguably only industrial action has an immediate solution.”
