Despite thousands of appointments being saved from cancellation due to effective planning and the dedication of NHS colleagues, reports of a much lower strike turnout and the public appearing largely sympathetic to the Government, this represented a major headache for the health secretary.

News the BMA had suspended strike action in August following talks, therefore, came as a great relief, although the spectre of more potential action remains. 

With nurses also voting to walk-out, Streeting could face the unenviable prospect of a tsunami of strike action as we head into winter. 

The fall-out with unions came at a particularly unfortunate time with the Government still bathing in the afterglow of a generally positive reception to its 10-Year Health Plan and having made good progress on increasing appointments and reducing waiting lists. Hostile unions could derail the ambitious vision of the plan and the Government's challenging productivity and elective care targets.  

For the highly ambitious Streeting, strike action has been a personal and political blow. It's no secret the secretary of state's ambitions may run all the way to Downing Street but ongoing industrial action could hamper his plans as evidenced by previous PM wannabes such as Jeremy Hunt. 

The pressure is on Streeting and Labour to get the unions back onside before lasting damage is done to both the Government and patients.