NHS England is concerned about the impact of junior doctor strikes on emergency care and efforts to tackle waiting lists, its chief strategy officer has said.

Chris Hopson told a summit hosted by the Nuffield Trust he expected the strikes to have a “bigger and wider spread” than industrial action held so far.

Junior doctors in England are set to walk out for three days from Monday March 13.

Nearly 40,000 junior doctors voted to take industrial action in the British Medical Association (BMA) ballot.

Talks between the BMA and Health Secretary Steve Barclay failed to an reach agreement on Thursday, with the strikes now set to go ahead.

We know that there will be greater numbers of staff involved - it will be just under half of our medical workforce, so 61,000 junior doctors

It is thought the BMA may not agree to exempt any areas of healthcare from the strikes (derogations), though staff can be recalled if there is an incident involving mass casualties.

Mr Hopson told health leaders: “I do think it’s really important to recognise that, were the BMA strikes to go ahead, then they will be greater in scale than we’ve seen before.

“All NHS organisations have junior doctors so it will be a bigger and a wider spread. The impact will be greater on the NHS – for example half of all GP practices actually have trainees.

“It will last longer in terms of it will be for 72 hours. The BMA have said publicly that they think it’s unlikely that there will be national level derogations which, as you know, have been really important in terms of managing for example, the nursing strike.

“And we know that there will be greater numbers of staff involved – it will be just under half of our medical workforce, so 61,000 junior doctors.

“We’re doing everything that we can. The bit that obviously we’re concerned about is not only the impact on urgent and emergency care, but also the impact in terms of the 78-week (18 month) elective target…”

He said the “trajectory where we were before Christmas” was that the NHS was on track to hit that particular target to reduce long waits by April.

“The issue is that the scale of those kinds of upcoming strikes represent a major challenge to delivering the target,” he said.

Mr Hopson also said the NHS was planning for the strikes but had already “lost 111,000 rescheduled appointments” due to industrial action.

Health bodies including NHS Providers and the NHS Confederation have urged the Government to hold talks to stop the strikes.

The Government has invited unions including the GMB, Unite and Unison to talks – something the unions have said they are considering.

Earlier this week, MPs said in a damning report the NHS will miss key targets for recovery of the health service, including treating people for cancer.

The cross-party Public Accounts Committee said the plan for tackling Covid backlogs, set out by NHS England and the Government last year, was already “falling short” and was based on “over-optimistic” assumptions about low levels of Covid and minimal pressure on the health service this winter.

There are currently around seven million people on the NHS waiting list compared to 4.6 million before the pandemic.

The MPs said: “NHS England’s three-year recovery programme for elective and cancer care is very ambitious, relies on innovative but relatively untested approaches, and is already falling short of expectations in its first year.”

It comes after ambulance chiefs have warned of a “significant escalation” in the strike action by unions next week across the country.

In a letter seen by the Health Service Journal (HSJ), the North West Ambulance Service said unions are “becoming more stringent in their approach” , with GMB and Unite not exempting category 2 calls from strike action.

Category 2 calls include conditions such as burns, heart attacks and strokes.