Junior doctor strikes “must not happen again”, NHS leaders have said, as they implored unions and the Government to settle the bitter dispute over pay.

Tens of thousands of juniors doctors in England started a 72-hour walk out on Monday morning.

The true extent of the disruption caused by the strikes is still emerging, but based on previous industrial action, it is likely that tens of thousands of appointments will have been postponed.

Usual activity was called off in many areas of the NHS as senior clinicians were deployed to cover emergency and critical care services.

Hospital leaders on the ground have said that the knock on effect will be “felt for some time to come”.

NHS Providers, which represents NHS trusts, urged the Government and unions to get round the table and “redouble” efforts to find a solution to the dispute.

But ministers and the British Medical Association appear to be no closer to reaching a resolution on pay, with the union urging Health Secretary Steve Barclay to drop a number of pre-conditions so they can enter talks.

Sir Julian Hartley, chief executive of the organisation, said: “As we head towards the end of this three day stoppage from junior doctors, the full extent of the disruption caused is still emerging.

“But one thing is very clear – for the sake of patients, staff and the NHS, this must not happen again.

“There is a very real human cost for patients in terms of treatment deferred, pain prolonged and continuing uncertainty.

“Consultants and other staff have stepped into the breach, but the NHS was already overstretched – morale is slipping and staff are exhausted.

“There is a financial cost as well, paying for strike cover diverts resources from other priorities.

“The NHS has so many big strategic challenges – not least recovering backlogs – something everyone wants to see. Strikes are a major and unwelcome distraction.

“The message to the government and unions is clear. Redouble your efforts to find a way through. No more strikes.”

Matthew Taylor, chief executive of the NHS Confederation, added: “For the sake of their patients and staff, health leaders will be glad the junior doctors strikes will be over shortly and hope that they never happen again.

“To guarantee this, the government and BMA need to find a way to move beyond their impasse, otherwise thousands more cancelled operations and appointments will be on their hands.

“Health leaders have told us that the third day of the junior doctors’ walkouts has felt more manageable than the previous two days, largely thanks to the extensive preparations that were made, including the support from consultants in covering shifts.

“However, services and in particular emergency care have still been extremely busy, with some members reporting that overnight is when bottlenecks in care can arise.”

NHS leaders on the ground have said that services will take “some time” to recover from the strikes.

Dr Andrew Kelso, medical director of NHS Suffolk and North East Essex, said: “I am very supportive of colleagues’ right to strike and understand their reasons for doing so.

“The knock-on effect of a three-day strike will be felt for some time to come.

“We will continue to do everything in our power to minimise disruption and prevent harm to patients.”

Accident and emergency departments at hospitals across England were under “severe pressure” on Monday, NHS England said.

Some hospitals said that they faced large numbers of patients who turned up unaware that the strikes were taking place.

The BMA is demanding “pay restoration” for junior doctors, who can have many years of experience and make up about 45% of the medical workforce.

The union says their pay has fallen in real terms by 26% since 2008/09 and reversing this would require a 35.3% pay rise.

Dr Emma Runswick, deputy chair of the BMA council, urged the Government to “engage meaningfully”.

Commenting on Chancellor Jeremy Hunt’s budget speech, she said: “To attract and keep staff we need to value them and pay them what they are worth. The Chancellor opened his speech by saying that ‘inflation destroys the value of hard-earned pay’.

“Which is exactly what has happened to doctors, with my junior colleagues having seen theirs slashed by more than a quarter in 15 years, leading them to take to picket lines this week.

“While he paid lip-service to working to ‘settle disputes’, there was no funding in today’s Budget that would convince us that the Government is serious about restoring junior doctors’ pay, and we urge ministers to engage meaningfully on this with us.

“This needs to be supported by investment. The argument that paying healthcare staff properly will fuel inflation simply will not wash.”