GP surgeries are suspending routine appointments to cope with this week's strike by junior doctors, it is reported.
More than 47,000 are expected to walk out for 96 hours from April 11 to 15 in a move which will "utterly overwhelm" the NHS, it is feared.
While many trusts have insisted the public will receive care as normal, patients in some areas have been warned to expect lengthy delays during the industrial action.
Others have been barred from booking appointments altogether, The Telegraph reports.
Granville House Medical Centre in Chorley, Lancashire, allegedly has no pre-bookable slots available for the coming week.
Elsewhere, only appointments considered urgent will be prioritised at Bacon Lane Surgery in Edgware, North London, and St Austell Healthcare in Cornwall.
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Health officials believe the four-day strike over pay, which begins at 7am tomorrow, will be the "most disruptive" ever.
Professor Sir Stephen Powis, national medical director for the NHS in England, said: "The NHS has been preparing extensively for the next set of strikes but managing additional pressure doesn't get easier as time goes by – it gets much more difficult, not only due to the sheer number of appointments that need to be rescheduled, but also that they can take time to rearrange with multiple teams involved.
"This is set to be the most disruptive industrial action in NHS history, and the strikes tomorrow will bring immense pressures, coming on the back of a challenged extended bank holiday weekend for staff and services.
"Emergency, urgent and critical care will be prioritised but some patients will unfortunately have had their appointments postponed – if you haven’t, please do continue to come forward."
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Up to 350,000 appointments and operations could be postponed, according to the NHS Confederation.
Last month's strikes saw 175,000 disrupted.
CEO Matthew Taylor told Sky News: "It's going to be an incredibly tough week.
"We've got four days of industrial action which of course come after the Easter Bank Holiday weekend, followed by another weekend, so you're talking about 10 or 11 days when the NHS is not able to operate at full strength."
"These strikes are going to have a catastrophic impact on the capacity of the NHS to recover services.
"The health service has to meet high levels of demand at the same time as making inroads into that huge backlog that built up before Covid, but then built up much more during Covid.
"That's a tough thing to do at the best of times – it's impossible to do when strikes are continuing.
"There's no point hiding the fact that there will be risks to patients – risks to patient safety, risks to patient dignity – as we're not able to provide the kind of care that we want to."
The British Medical Association wants to see pay increased 35 per cent.
But writing in The Telegraph, Health Secretary Steve Barclay described this as "unrealistic", particularly at a time of "considerable economic pressure".
Junior doctors make up around half of all doctors in the NHS, according to NHS England.
They are qualified doctors who have up to eight years' experience working as a hospital doctor, depending on their speciality, or up to three years in general practice.
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The health service said people must still access the care they need in the usual way, only using 999 and A&E in life-threatening emergencies and using NHS 111 online and other services for non-urgent health needs.
Trainee GPs are also taking action. Practices have been "strongly advised" to cancel any clinics scheduled for trainee staff on strike days.
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