Health Secretary Steve Barclay was under pressure today after the British Medical Association offered to allow the arbitration service ACAS to oversee talks on the trainee doctor pay dispute.

An agreement to go to ACAS would almost certainly mean the immediate suspension of this week’s strikes – the hardest hitting walk-out the NHS has ever experienced, leading to many practices to cancel appointments. The dispute has been marked by a war of words between the medical unions and Health Secretary Steve Barclay, with both sides accusing the other of setting unacceptable preconditions for talks. The BMA responded to a plea from the NHS Confederation for both sides to agree to use ACAS.

Dr Vivek Trivedi, one of the chairs of the BMA’s junior doctors’ committee, tweeted last night: “Any route to help break the deadlock that @SteveBarclay has created is welcome. Important for those with reservations surrounding 2016 – ACAS can bring the govt to the table. They do not move/recommend negotiating positions or deals. We are happy to negotiate.”

He was referring to the 2016 trainees dispute, which centred on a new contract. Strikes led to talks but doctors then rejected the subsequent deal. It led to a contract being imposed which included the 2% annual pay rises that have led trainees lagging behind other staff groups.

NHS Confederation chief executive Matthew Taylor said mental health care had proved a particular concern for maintaining staffing.

He said: “While members are telling us that the NHS is holding firm, the full impact will not be known straight away. NHS staff are doing all they can to minimise disruption, but with junior doctors making up nearly two fifths of an already understaffed workforce, NHS leaders are understandably worried about the further impact this walkout will have on their services. Our members have scaled back elective operations and appointments to prioritise emergency care and other areas of care. They have planned well, with many telling us they do not think they will have to cancel more procedures than they already have. Despite this, the national situation continues to be fragile – not least because the strikes follow the Easter weekend when more NHS staff tend to be on leave.

“The good news is that many of our members are reporting good levels of cover being provided by consultants, SAS doctors and other healthcare professionals, with many expressing gratitude towards their clinical teams and commending their professionalism. But many leaders acknowledge that it has been more difficult to plan rotas this time round, particularly during a busy holiday period, and are concerned about the reduced resilience they have to cope with any potential unforeseen absence.”

He added: “Finally, we continue to urge the government and unions to resume talks to find a way through this damaging impasse. For the sake of patients, we have called for the BMA and the Secretary of State for Health and Social Care to engage with ACAS over the dispute around junior doctors pay, to help bring the current industrial action to an end.”

BMA chair Professor Philip Banfield said: “We have always said we will get round the table for talks with Mr Barclay any time; a credible offer from him could result in strike action being called off, but despite months of trying, he remains seemingly intransigent and inflexible to all our attempts to reach a settlement. The BMA has no preconditions to talks and has consistently sought to negotiate with the Government. Restoring junior doctors’ pay should not be an unworkable proposition for talks and through the services of ACAS, we’re offering the Government an opportunity to discuss how we get there. It takes both sides of a dispute to want to find a solution and we urge the Health Secretary to show the same willingness that we have and make himself available and open to talks facilitated by ACAS.”

A Department of Health spokesperson told the BBC: “We’ve been engaging with ACAS during this dispute and remain open to considering whether there is a role for them to help us reach the desired outcome – an end to strike action which is putting patient safety at risk. But our position remains that the junior doctors’ council needs to significantly reduce its demand for a 35% pay increase and pause action for formal talks to begin and that will not change.”