Hundreds of appointments and more than 60 operations have been cancelled at a Norfolk hospital because of recent strikes by doctors.
Junior doctors across England took part in a 72-hour period of action from December 20 to 23 and a further six days of action from January 3 to 9.
A report to the board of directors at the Queen Elizabeth Hospital in King's Lynn by its chief executive Alice Webster says the number of staff participating in the industrial action ranged from 56pc to 72pc.
It adds: "Throughout this challenging period, we continued to provide urgent and emergency care, but unfortunately had to reschedule 576 outpatient appointments and postpone 66 elective procedures to ensure patient safety.
"Only seven of the 66 elective patients were cancelled on the day of surgery, all were re-booked within 28 days."
The British Medical Association's dispute with the government over pay remains unresolved.
It has announced further strike dates in England, from February 24 to 28, while it is also balloting its members over a further six months of strikes.
BMA junior doctors committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said: "We have made every effort to work with the government in finding a fair solution to this dispute whilst trying to avoid strike action.
“The glacial speed of progress with the government is frustrating and incomprehensible."
They added they were willing to cancel forthcoming strikes "if significant progress is made and a credible offer is put forward".
Health and Social Care Secretary Victoria Atkins said: "This action called by the BMA junior doctor committee does not signal that they are ready to be reasonable.
“We already provided them with a pay increase of up to 10.3% and were prepared to go further."
She added she wanted to focus on cutting waiting times for patients rather than industrial action.
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