NHS Providers and NHS Confederation urged chancellor Rachel Reeves to cover the costs or risk the NHS having to cut staff and services to make up the shortfall.

Matthew Taylor, chief executive of the NHS Confederation, said: ‘The threat from un-budgeted redundancy payments, higher drug prices and renewed industrial action risks derailing progress on key waiting time targets and the wider reforms that are essential to getting the NHS back on track.'

The three unplanned cost pressures include over £1bn to reduce running costs at ICBs by 50%, £300m due to industrial action with more BMA action planned in November and higher potential drug prices as a result of pressure from the US Government.

Members of both organisations warned progress on hitting the 18-week target for planned care will be jeopadised and minimum waiting times for treatments increased if the Government does not act.

Daniel Elkeles, chief executive of NHS Providers, said: ‘The NHS is being left with a stark choice. Either balance the books or cut waiting lists and face more deficits which threaten services.'

Elkeles called for ‘an honest assessment and discussion about what the NHS can really achieve this year'.

A Department for Health and Social care spokesperson said: ‘This Government has delivered a record-breaking £29bn investment in our NHS – including up to £10bn on digital and technology transformation and £750m for urgent capital repairs – demonstrating our unwavering commitment to properly funding the health service that we all rely on. 

‘We know that needless strikes will divert money, time and resourcing away from the front line. That's why the health secretary has urged the BMA to stop being selfish and start putting patients first. 

‘However, investment alone isn't enough - it must go hand in hand with reform. That is why we're doing things differently: not just fixing the NHS but moving it forward through our Plan for Change.

‘And it's already working. We've taken over 200,000 people off waiting lists, delivered 5m more appointments and GP satisfaction is finally going up.'