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Over 175,000 patient appointments and procedures had to be cancelled in England when junior doctors went on strike this week, figures reveal.
That makes it the most disruptive NHS strike yet this winter.
Tens of thousands of medics took part in the 72-hour walkout, which began on Monday, with more senior hospital colleagues asked to cover.
Emergency care was still provided but many planned non-urgent treatments were rescheduled.
NHS England medical director Prof Sir Stephen Powis, said: "Despite the huge efforts that NHS staff made to keep patients safe and minimise disruption, this strike was on an unprecedented scale and had a greater impact than all the other industrial action we have seen so far this winter combined.
"Over 175,000 appointments and procedures were rescheduled to protect emergency, critical and urgent care for patients, which will inevitably impact on efforts to tackle the Covid backlog."