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Hospital bosses fear a “nightmare” scenario if a second junior doctors’ strike goes ahead as it will coincide with a proposed Tube strike, the Standard can reveal.

Contingency plans are being ramped up across the London NHS amid major concerns that a total shutdown of the Underground on January 26 will make it even harder to provide cover for absent junior doctors.

This could lead to far greater impact on patients than the first doctors’ strike on Tuesday, when 522 operations were postponed in the capital and thousands of outpatient clinics were cancelled.

Today the Standard can also reveal that hundreds of non-urgent operations were postponed by NHS chiefs over Christmas when 28 “struggling” trusts were ordered to “clear the decks” to avert a feared winter meltdown in A&E.

Hospitals were told by the Trust Development Authority to reduce bed occupancy to 80 per cent by Christmas Eve to ensure there was spare capacity to admit patients taken unwell over the two-week festive period.

Barts Health, which has five east London hospitals and is currently in special measures, was one of those told to free-up beds. Another was London North West Healthcare, which runs Northwick Park and Ealing hospitals. Croydon said it only carried out urgent operations.

Barts’ chief operating officer Jacqueline Totterdell said cancer patients and those on the waiting list for more than a year had their operations proceed as normal. She said the system worked well as it enabled 90 per cent of its A&E patients to be seen within four hours for most of the period.

“Staff felt this was one of the better times we have had over the Christmas and New Year period,” she said. “It didn’t feel chaotic. It felt calm and in control.”

Barts Health, the country’s biggest NHS trust with five east London hospitals, was forced to cancel 100 operations and 17 per cent of clinics when junior doctors went on strike on Tuesday. Talks between the Government and British Medical Association were resuming today at Acas.

One senior NHS boss told the Standard it would “be a nightmare” if a 48-hour doctors’ strike due to start at 8am on January 26 went ahead as it would overlap with a walkout called by three unions in dispute over the Night Tube. Tube unions are also due to strike on February 15 and 17, while junior doctors have planned a third walkout – including A&E and maternity departments for the first time – on February 10.

A spokeswoman for NHS England (London) said: “We are aware that the next planned  industrial action by junior doctors coincides with a potential Tube strike.

“We are currently taking steps to plan for this and we are working closely with the London Ambulance Service, all healthcare providers in London as well as other agencies across the capital to ensure that patients will continue to receive the care they need during this time.”

A spokesman for the Trust Development Authority said: “The Christmas and winter period always places extra demand on the NHS – that is why we worked with all hospitals to ensure they were fully prepared to meet this challenge.

“Having sufficient bed capacity going into Christmas is key to a trust’s ability to respond to high levels of patient demand. By working with trusts to manage planned non-emergency operations and helping patients to get out of hospital more quickly we can make sure they have enough free beds to cope with the rising number of patients needing emergency care.”

A spokesman for Croydon Health Services NHS Trust said: “We did not cancel operations this Christmas but, as part of our planning for the year, we carried out only urgent operations.  We did this to make sure we had enough capacity to care for the very sick during one of our busiest times.

“Reducing the number of planned operations over Christmas is not unusual.  This helps us to free-up hospital beds to care for more people safely and in the shortest time possible – including those in life-critical conditions.”