Disruption to patients 'more limited than feared'
Patients have had appointments and surgery cancelled due to industrial action by doctors but the total impact appears more limited than feared.
British Medical Association members across the UK have been boycotting non-urgent care in a dispute over pensions.
The government said NHS figures suggested 10% of hospital patients in England had had care cancelled, while a quarter of GP practices were affected.
But the union said the intention of the day was never to maximise disruption.
In the lead-up to the day of action, the BMA leadership was always clear that doctors would turn up for work and ensure emergency and urgent services would run.
This has meant that GP surgeries, A&E units and maternity departments were always going to remain open while tests for conditions such as cancer would still take place.Warnings
But as the day of action has progressed it has become clear many doctors have also carried on seeing non-urgent patients - in fact the government said it believed only 8% of doctors took part.
It said the impact of this in England was that 2,700 non-emergency operations had to be cancelled and nearly 19,000 hospital appointments were put back - which in both cases amounts to a tenth of the workload.
About 2,000 GP surgeries - a quarter of the total - also took part by seeing only patients with urgent illnesses or injuries.
The government figures are supported by information released by local NHS trusts.
Dr Naveem Akram is a partner of a GP surgery in Swansea. He is handing out flyers to his patients so they understand what is happening.
But he says patients needing care on the day are being seen. Only the routine follow-up appointments and medicine reviews have been put off.
"I don't want any disruption and inconvenience to patients but I want to do something to show that I am not in favour of the changes.
"From a professional point of view, this is not a nice position to be in. We're hardwired to look after patients so to do something like this is not nice.
"But these changes pretty much double my pension contributions. The argument that the current pension scheme is not sustainable is wrong. "
- Birmingham's Queen Elizabeth Hospital has only cancelled three out of 100 non-emergency operations and 38 out of 2,000 routine appointments.
- In Northamptonshire eight out of 10 surgeries were offering normal or near-normal services.
- One in 10 operations have been hit at the Norwich and Norfolk Hospital and 71 out of 1,400 routine appointments.
- Barnsley Hospital has cancelled eight operations and a quarter of outpatient appointments.
- Across London nearly 500 operations have been cancelled - 10% of the total - while one in 10 appointments have had to be rearranged.
Elsewhere in the UK, the number of hospital cancellations was similar.
However, in Scotland more GP practices seem to have been affected with the government saying about 60% of centres took part.
But the BMA warned that the government figures needed to be treated with caution.
It said feedback from its members suggested that there was greater disruption with up to a quarter of non-urgent care affected.
Nonetheless, the picture contrasts with warnings from Health Secretary Andrew Lansley in the lead-up to the action.
He said many of the 30,000 non-emergency operations, including knee and hip operations, 200,000 hospital appointments and 1.25m visits to GP surgeries in England could be hit.
But patients who have been affected were angry.
Mark Catterall, from Poole, Dorset, told the BBC: "I've had an operation cancelled and now it looks like it will be August at the earliest.
"I think they [doctors] live in a bubble and really need to look at the bigger picture."Argument
Mr Lansley said doctors had been wrong to "penalise" patients.
But he added: "In the run-up to these strikes our objective has been to minimise disruption for patients.
What it means for patients
- The NHS is advising patients who need help in an emergency to use the service as they normally would
- Accident and emergency units are open, while mothers in labour are able to go to maternity departments
- Appointments for urgent tests, such as for cancer, have also been continuing
- Routine appointments and operations have been affected
- Hospitals should already have told some patients their care has been rearranged
- Appointments could be cancelled on the day as doctors do not have to tell their employers they are taking action
- GP surgeries have been open and were taking emergency appointments
- Advanced GP appointments for things such as medicine reviews or follow-ups have been cancelled by doctors taking part
- Dentists are not involved and so services have been running as normal
"We asked doctors to recognise that their quarrel was not with patients but with the government.
"I am pleased that a significant majority of doctors have done just that and maintained services for their patients."
BMA chairman Dr Hamish Meldrum said the action should not be judged solely on the impact felt by patients - because it fell short of a full strike.
"It has never surprised me that when it came to the crunch a lot of doctors do not want to take this out on patients."
The BMA has argued the government is wrong to try to change the current arrangements because a new deal was only agreed in 2008.
It has pointed out that the current scheme is bringing in a surplus of £2bn a year and under the new plans they are being asked to contribute much more than other high earners in the public sector.
Under the plans, doctors will be asked to work for longer - until 68 - and contribute more of their pay.
But ministers have insisted the changes, which apply to England and Wales but could be introduced elsewhere in the UK, are necessary.