The impact caused by the longest walkout in NHS history could last for months, NHS leaders have said.

Junior doctors in England concluded their six-day walkout at 7am on Tuesday.

Health service leaders said that that the action was called at “one of the most challenging times of year” due to a rise in winter bugs and increased pressure from cold weather.

It comes amid reports that junior doctors will hold a fresh ballot for more strike action.

The longest strike in the history of the NHS may be over, but the impact on the health service will be felt for weeks and months to come

The British Medical Association’s (BMA) junior doctors’ committee has plans to hold a third vote for a new six-month mandate for industrial action over the long-running pay dispute, according to The Guardian.

NHS England’s national medical director, Professor Sir Stephen Powis, said: “Colleagues across the NHS have worked incredibly hard to keep patients safe during strikes, but that work doesn’t end today.

“The longest strike in the history of the NHS may be over, but the impact on the health service will be felt for weeks and months to come.

“Staff who have been covering striking colleagues will understandably need a break, but the health service must continue to navigate one of the most challenging times of year, with flu and Covid expected to continue rising during January and cold weather adding to pressures on services.

“This is on top of ensuring that the thousands of people who have had elective appointments unavoidably postponed due to the latest rounds of industrial action are able to get the tests, checks and treatment they need as soon as possible.”

NHS officials prioritised emergency care during the walk out and the vast majority of pre-planned work was postponed.

A number of critical incidents were declared by hospitals during the walkout, while many described extreme pressure.

Health commentators have called for the Government and BMA to urgently get back round the table to try end the bitter dispute over pay.

On Monday, Health Secretary Victoria Atkins said she would sit down to negotiate with junior doctors if they enter talks with “reasonable expectations”.

She told the Commons it is time for the junior doctors’ committee to “show that they’re serious about doing a deal”.

Meanwhile NHS England chief executive Amanda Pritchard praised staff who have worked throughout the action, including junior doctors who either chose not to take action or returned to work to ensure patient safety was maintained.

In an update sent to NHS leaders, she said patients in need of time-sensitive treatment “are left shouldering the greatest personal risk” – including those with cancer.

She said more “repeated periods of ever-more drastic action” is “not sustainable”.

The BMA has said junior doctors’ pay has been cut by more than a quarter since 2008.

Junior doctors in Northern Ireland are being balloted for the first time over potential strike action.

If BMA members vote for strike action, medics will stage a 24-hour full walkout, the BMA’s Northern Ireland junior doctors’ committee said.

Meanwhile, junior doctors in Wales are set to stage a 72-hour walk out from Monday January 15.

Junior doctors in Scotland settled their pay dispute last summer.