Pharmacists will be drafted in to help break NHS strike action and ease winter pressures on the NHS, under plans being considered by ministers.
Chemists could be allowed to diagnose patients with minor conditions and prescribe antibiotics for the first time to try to reduce demand for GP appointments and cut record backlogs.
Ministers are braced for the cancellation of thousands of elective procedures and screening appointments as up to 100,000 nurses walk out later this month over a pay dispute.
On Saturday Steve Barclay, the Health Secretary, wrote to the Royal College of Nursing (RCN) and GMB unions that are threatening the strike action, urging them to maintain minimum staffing levels to protect accident and emergency services, which the unions have refused to ring-fence.
Chemotherapy, critical care, kidney dialysis, paediatric intensive care and neonatal services have been given protection from strikes by the RCN, but others remain at risk on Dec 15 and 20.
While progress has been made on some of the nurses’ complaints, including the cost of parking and security in emergency units, the strikes are likely to go ahead and carry on in the new year if ministers do not agree to the unions’ demand for an above-inflation pay rise.
Under plans to use community pharmacists to ease pressure on the NHS, chemists would be allowed to prescribe for minor conditions, including antibiotics for women with urinary tract infections (UTIs) and creams for those with skin infections.
They would also be given powers to diagnose patients with Strep A, after an outbreak in children that has killed six and prompted a warning to parents from the UK Health Security Agency.
Allowing pharmacists to take on greater responsibility would cost an estimated £400 million and divert around 65 million appointments away from GPs each year, according to analysis by the Pharmaceutical Services Negotiating Committee (PSNC).
But the plan is unlikely to be deployed before Christmas because it will take time to train staff and arrange NHS contracts for private pharmacies, but it would take pressure off the health service if strikes continue as planned.
A similar plan was considered under Thérèse Coffey’s tenure in the Department of Health earlier this year, but shelved amid concerns about a backlash from GPs and the effect on antimicrobial resistance.
The Telegraph understands that it has been resurrected in the face of a tough winter and record backlogs, with more than seven million Britons waiting for treatment.
Hospital bosses are drawing up a list of thousands more procedures that will be cancelled if the strikes go ahead, including cancer screenings and routine surgery.
It comes after Cabinet ministers in departments most affected by strike threats, including the Home Office, Transport, Health and Education, gathered this week for a series of Cobra meetings to coordinate their response.
“Clearly the unions have been talking among themselves and there is some coordination between them going on,” said one official.
In an interview with The Telegraph, Dave Ward, the general secretary of the Communication Workers’ Union (CWU), said Britain was facing a “de facto general strike” because of the scale of action in different sectors.
Mr Ward said his union was “involved in other campaigns” as well as its own against Royal Mail this Christmas.
“The CWU has been a union that’s been calling for a new deal for workers,” he said. “A serious look at insecurity of work. A serious look at the balance of forces in the world of work.”
Military personnel have begun training to prepare to step in for striking Border Force, ambulance and fire service staff, who have all threatened to walk out over pay.
This week troops attended an “orientation” session at Heathrow Airport to prepare them for a Border Force strike, threatened by the PCS union.
A government source said that the PCS’s strikes were “all about helping their friends in the Labour Party”.