The two hospitals closest to Richmond have said they may need to cancel some patients’ appointments at short notice today, as health workers take part in the national strike. West Middlesex Hospital and Kingston Hospital said they had negotiated with trade union representatives to ensure they could still provide emergency care.

However, they may need to cancel outpatient and other routine appointments such as x-rays. Hospital staff will contact patients directly today if they need to re-book.

They asked residents to think twice about going to the accident and emergency department, unless it was a genuine emergency. Ambulances also may not respond to 999 calls for minor illnesses today.

Anne Gibbs, director of operations at West Middlesex Hospital, said: “Inevitably there may be some disruption to our services and we ask patients to bear with us while we concentrate on caring for the least well and those with life threatening injuries or illness first.”

West Middlesex Hospital will ensure its intensive care and high dependency units, radiology, physiotherapy and A&E departments, in-patient and maternity labour wards, theatres for urgent and life threatening surgery and cancer clinics are all staffed today.

A spokesman for Kingston Hospital said: “We have business continuity plans in place to ensure our emergency services such as A&E and emergency surgery will be running as usual. We will be monitoring the impact of the strike throughout the day.

“If services are affected more than anticipated there may be some short notice cancellations to some planned outpatient appointments and other routine appointments, such as x-rays, which will then be rearranged.

“We will contact patients directly on the day if their appointment is affected.”

Dozens of teachers across the borough have joined the strike and Richmond Magistrates’ Court was closed today as public sector workers walked out in a pensions dispute with the Government.

Kew Gardens also shut its doors as staff took part in the industrial action.

Members of the PCS, Prospect and GMB unions at the attraction said workers there had already suffered a two year pay and recruitment freeze.

Unison members also stood on the picket line outside Richmond Council’s headquarters, in York Street, Twickenham.

John Holroyd, secretary of the Richmond branch of Unison, said: “We are not really striking to hurt the council, we are only trying to draw attention to the national struggle – the key is the national dispute.”