He said: “For the sake of clarity, we must, once again, reject your assertion that the only outstanding issue in dispute relates to Saturday pay. Your own letter recognises a number of critical issues concerning work-life balance, excessive working hours, improvements in training and crucially, workforce and funding implications for seven-day services.

“The proposed contract is deficient in failing to address these issues properly.

“I hope that even at this stage we can find a way to step back from this dispute, from the imposition of a distrusted contract, and from the consequent industrial action.”

Freedom of Information disclosures have revealed emergency measures already taken by NHS trusts in the months ahead of the strikes. The new figures show that 58 out of 152 NHS trusts experienced “serious operational problems” between December and February – forcing them to cancel operations, divert patients away from Accident & Emergency patients or leave patients stuck in queues of ambulances outside casualty units.