According to the NHS Providers annual State of The Provider Sector survey, nearly two-thirds of trust leaders (64%) were worried about the potential impact of industrial action.

Daniel Elkeles, chief executive of NHS Providers, said: ‘More strikes now could crush this fragile, hard-won progress, wiping out a once-in-a-generation opportunity to fix the health service.  

‘And just ahead of the Budget, let's remember strikes come at a financial cost. That's money the NHS does not have.

‘We're starting to shift the dial. Let's all face forward together to build the better NHS that patients deserve.'

Key finding from the report include:

• 52% said the quality of care in their area was high or very high, up 11 percentage points on last year and the most positive finding on this indicator going back to before the pandemic
• 53% said they had the right number, quality and mix of staff, up from 40% last year. However, there were deep concerns about staff burnout (79%), discrimination towards staff from patients and the public (77%), and morale (74%)
• just 9% agreed that investment in mental health services matched demand. More than half (60%) said mental health services lacked the capacity to reduce waits and intervene earlier
• 37% described last winter as the most challenging of their NHS careers. 67% said they expected this winter to be tougher, however, the survey showed they were putting in place a range of initiatives to ensure safe, high quality care.

Rory Deighton, acute and community care director at the NHS Confederation, said: ‘There is no hiding from the fact that continuing and prolonged industrial action this winter would make it almost impossible for the health service to reduce waiting lists and implement the vital reforms needed to put the NHS on a sustainable footing.'

A Department of Health and Social Care spokesperson said: ‘The health secretary has been clear that this week's planned strike action from the BMA is unnecessary, irresponsible and risks damaging the significant progress we've made in rebuilding our broken NHS.

‘We are working tirelessly to reach a fair resolution that keeps doctors on the wards where they are needed most. At the same time, we are bracing the NHS against the impact of strikes, and putting patients first as we ramp up preparations for what could be a challenging winter.'