NHS leaders have issued an urgent appeal to the public to only use accident and emergency, and 999, in life threatening conditions.

It comes as the health service continues to face disruption as workers from various unions walk out on strike over the coming days.

Emergency and urgent care centres across the North East will remain open today (December 20), and on Wednesday December 21 and 28 when ambulance staff strike in an ongoing pay row.

Dr Neil O'Brien, executive medical director for the North East and North Cumbria Integrated Care Board, said: "Please only use 999 and accident and emergency departments for life threating injuries and illnesses.

"If you need advice for an every-day illness or injury, please either contact your local pharmacy for help or look at the self-care advice that’s available on-line from the NHS at www.nhs.uk.

"You can also check your symptoms, using the on-line symptom checker available at www.111.nhs.uk, which will re-direct you to a health professional if you need to be seen by someone. If your symptoms persist and you are not getting better, please contact your GP practice for advice.

"We do have plans in place during the industrial action with support being prioritised for those who are most poorly. We are expecting services to be busy, and this is likely to lead to long delays for non-urgent treatment – please use NHS services sensibly."

It comes as nursing staff at three NHS hospital trusts in the region – Gateshead’s QE, Newcastle Hospitals and Northumbria Healthcare – joined picket lines on Tuesday (December 20) morning in an ongoing row over pay and conditions.

Patients are being encouraged to attend appointments unless they hear otherwise.