THE NHS is entering “uncharted territory” today with the start of four days of strikes involving consultants and junior doctors.

Thousands of patient appointments are expected to be cancelled this week, with a “Christmas Day” level of staffing when both categories of medics are absent from work tomorrow.

Nearly a million routine procedures have been cancelled during 10 months of industrial action, which is estimated to have cost the NHS at least £1 billion so far.

NHS Providers deputy chief executive Saffron Cordery said the strikes would be the “toughest test yet for trust leaders, ramping up pressure on already stretched services.

“We’re in uncharted territory. It’s all hands on deck in trusts across the country,” he said.

“Strikes can’t become the status quo. Only the government sitting down with the unions can end this disruption.”

Consultants are walking out in a dispute over pay today and tomorrow as well as on October 2, 3 and 4.

Junior doctors, who have staged 19 days of strike action since March, will walk out tomorrow, on Thursday and Friday and on October 2, 3 and 4.

The British Medical Association is calling for “full pay restoration” to 2008-09 levels.

It estimates that the value of junior doctors’ pay was eroded by 26 per cent up to 2021-22 and that, using the retail prices index rate of inflation, it would need to rise by 35 per cent from that level to regain the value it had in 2008-09.

The government has ruled out further offers after implementing a 6 per cent pay rise for consultants and 6 per cent plus a lump sum of £1,250 for junior doctors.

Health Secretary Steve Barclay claimed to be open to discussions about the “non-pay elements” of the imposed settlement, but he said that there were no plans to revisit the salary package.