The NHS is warning of ‘unprecedented disruption’ this week as joint strikes by junior doctors and consultants could leave hospitals with staffing levels akin to those available on Christmas Day.

The strike by doctors in England at all levels is expected to lead to the cancellation of thousands of appointments and a pause in almost all planned care for up to four days.

Consultants in England are striking for 48 hours from Tuesday (September 19).

They will then be joined by their junior colleagues on Wednesday, who are beginning a 72-hour walkout, as medics continue their dispute with the government over pay and working conditions.

Those with appointments for routine or planned care are to be contacted by the Trust responsible for their care if their treatment is affected by the disruption – while in emergency situations people are being told to use 999 and A&E as they normally would.

Both consultants and junior doctors are expected to then strike again together on October 2, 3 and 4 – at the same time that the Conservative Party Conference takes place in Manchester – as part of efforts to heap further pressure on Rishi Sunak’s government.

Speaking ahead of the combined strikes, NHS national medical director Professor Sir Stephen Powis says the health service had “never seen this kind of industrial action in its history”.

He added: “This week’s first ever joint action means almost all planned care will come to a stop and hundreds of thousands of appointments will be postponed, which is incredibly difficult for patients and their families, and poses an enormous challenge for colleagues across the NHS.”

NHS waiting times are already at a record high, according to figures released earlier this month, with 7.7 million people waiting for treatment or the equivalent to around one in every seven people.

And there are fears with winter on the horizon, and a new variant of Covid-19 in circulation, that NHS services could face an extremely difficult winter trying to tackle growing waiting lists while managing an influx in patients suffering complications caused by flu and coronvirus.