Junior doctors walked out on their second 24 hour strike at 8am this morning (Wednesday).

The walk out is part of an ongoing dispute with the government over proposed contract changes involving pay and working hours and for 24 hours junior doctors will only provide emergency care.

Barking Havering and Redbridge University Hospitals NHS Trust has warned patients they may have to wait longer than usual and should seek help elsewhere if not in an emergency situation.

Speaking on Radio 4’s Today programme this morning the trust’s chief executive Matthew Hopkins said 45 operations and 151 outpatient appointments had been cancelled.

He described the disruption as less severe than at the first walk out in January.

“As a former nurse and chief executive my main concern is making sure our services high quality and safe for patients.

“Any situation where we have to plan for changes to the way we deliver our outpatient and our operations is clearly unhelpful and that disruption for patients I would like to apologise for, but we have tried to minimise it as best we could today,” Mr Hopkins told the BBC programme.

The British Medical Association’s junior doctors committee chair Johann Malawana said: “The Government’s entrenched position in refusing to recognise Saturday working as unsocial hours, together with its continued threat to impose a contract so fiercely resisted by junior doctors across England, leaves us with no alternative but to continue with industrial action.”

The trust has recommended people not requiring urgent or emergency care look for alternative such as NHS 111, walk-in centres, GPs or pharmacies.