There has been no let-up in patient demand for care during the junior doctors strike this week, the chief executive of NHS Providers’ Sir Julian Hartley has said, adding that the knock-on effects of the strike will be felt for ‘a long time to come’.

He said that while senior doctors were ‘stepping into the breach’, ‘it isn’t business as usual’, adding that there were delays to hospital admissions and discharge as well as ambulance handovers.

‘Unlike previous strikes, it’s noticeable that there has been no let-up in the demand for care’, he added, urging the government and the doctors’ unions ‘to come to an agreement quickly.’

Meanwhile, NHS England said that for some A&E departments, yesterday was the busiest Monday of the year so far.

On Saturday, NHS medical director Professor Sir Stephen Powis said that the NHS would prioritise resources to protect emergency and critical care, instead directing the public use pharmacies, as well as GPs and 111 online, as first points of call.

He added that ‘people should of course always use 999 in a life-threatening emergency.’

But the Pharmaceutical Services Negotiating Committee (PSNC) said yesterday that the NHS must stop directing patients to community pharmacies without providing additional funding such as a fully funded Pharmacy First service.

Nathan Burley, chair of the Guild of Healthcare Pharmacists (GHP), said that pharmacists working alongside junior doctors during the strike – for example, in GP surgeries – should not take on any work outside their scope of competence or job description as this ‘would not be appropriate or safe’, and should not work additional hours ‘as to do so would undermine lawful industrial action taken by junior doctors’.

He added: ‘The erosion of pay for practically all NHS-employed healthcare staff is stark when taking inflation into account. Industrial action is the last choice for any healthcare professional but hinges on the Government pushing real-term pay cuts for many years and continued refusal to negotiate.’

The Pharmacists’ Defence Association (PDA) also said that PDA members ‘in any setting’ should practice within their training and competency, and their defined role and job description, and added that ‘those taking lawful industrial action should also be assured that PDAU members will not undertake work that those on strike would normally have carried out if this is at all avoidable’.