A strike by junior doctors is to go ahead next week after last-ditch talks over the health secretary’s plans to impose a new contract on them failed to break the deadlock, the negotiating service Acas has said.

While it called Friday’s negotiations constructive and said they would continue next week, a spokesman for Acas said they were not enough to avert the industrial action, which is due to start on Tuesday.

About 45,000 junior doctors in England voted overwhelmingly in favour of strike action and will provide only emergency cover.

Doctors have previously blamed the government for failing to address their concerns about the “need for robust contractual safeguards on safe working, and proper recognition for those working unsocial hours”.

Earlier this week, Jeremy Hunt said the planned strikes were “extremely disappointing”, adding: “We had made good progress in talks, resolving 15 of the 16 issues put forward by the union – everything apart from weekend pay.”

The news came as a host of NHS trusts were put on the highest alert. The health service is already struggling to cope with high patient demand across England, Wales and Scotland, leaving some facilities with more patients than beds.

Trusts in Essex, Cornwall and Bristol, as well as others in Somerset and Gloucestershire, issued black alerts, while others drafted in more staff to try to meet the demand.

Some planned operations and outpatient clinics were cancelled, although cancer-related and emergency surgery was still due to go ahead.

Southend university hospital NHS foundation trust and Basildon and Thurrock university hospitals NHS foundation trust issued the highest alert. They were joined by Royal Cornwall hospitals NHS trust and the health system across Bristol, North Somerset and South Gloucestershire, which declared a “system-wide black escalation” status.

In Bristol, trusts took steps to try to cope with the high demand. University Hospitals Bristol, which runs Bristol royal infirmary, Bristol royal hospital for children and South Bristol community hospital, called in additional clinical staff, as well as implementing other measures.



North Bristol trust, which runs Southmead and Cossham hospitals, has extra senior nurses, extra winter bed capacity and additional transport. And Weston Area health trust is making extra beds available, with the senior nursing team working over the weekend.

Colchester hospital university NHS foundation trust has been on black alert since Tuesday, when it had an influx of patients, but this was downgraded to the less severe “amber” on Friday morning.



Maidstone and Tunbridge Wells NHS trust is not on black alert but said it was “currently in a period of high demand for services” with high numbers of patients in A&E, meaning it could become necessary to transfer patients between hospital sites.

Torbay hospital has been on red alert, the second most severe, for days.

Hospitals in Britain have had to send patients elsewhere 89 times in the last five weeks because they were too busy to treat them. The official figures, released on Friday, showed that English hospital trusts had encountered “operational problems” more than 140 times since the end of November.

The NHS has an internal alerts system, which ranges from green, the least severe, through amber and red, which means there is pressure on beds but the hospital has not had to close, to black, which indicates there are more patients than there is capacity to treat them.



Please call NHS 111 if you urgently need medical help or advice but it's not a life-threatening situation: https://t.co/G6WZWrAzzU — Basildon Hospital (@BasildonHosp) January 7, 2016

Other trusts issued alerts earlier in the week and asked people to avoid A&E units where possible because they were “extremely busy”.



Officials at Abertawe Bro Morgannwg university health board said the Morriston and Princess of Wales hospitals in Swansea and Bridgend had a high number of emergencies that caused delays.

All three of Norfolk’s main hospitals experienced black alerts this week, with a spokesman for the Queen Elizabeth saying on Friday that it remained at the highest grade, although its status could change overnight. A spokesman for the James Paget hospital said it was on red alert.

NHS leaders in Northamptonshire have been urging the public not to attend hospitals “unless absolutely necessary”.

Attendances at both Kettering and Northampton general hospitals have continued to rise since the new year “which is causing significant pressures in both A&E departments”, a statement said, leading to the cancellation of some routine operations.

A spokeswoman for Northampton general hospital, which has had to cancel non-urgent operations, said it had not declared a black alert, but had experienced significant pressure.

Somerset clinical commissioning group issued a black alert on Wednesday for the whole health system, but has since downgraded it to red.

The Countess of Chester hospital NHS foundation trust said it had been prioritising people with life-threatening and serious medical conditions.

Wrightington, Wigan and Leigh NHS foundation trust said it was on red alert and was “experiencing very high levels of attendance” at its A&E.

And Burton’s Queen’s hospital closed its doors temporarily on Monday to patients arriving in ambulances.



In Scotland, some operations have had to be cancelled and patients have experienced long waits in A&E departments. As of Wednesday, some patients were being redirected from Aberdeen royal infirmary and procedures had been postponed. NHS Grampian said it has been experiencing “seasonal pressures”.