GPs are planning to circumnavigate the postal strike in order to ensure vulnerable patients are vaccinated against swine flu.
Originally it was planned to send appointment letters to 14 million people from priority groups with doctors starting to get the vaccine this week.
But with more strikes having started, GPs have said they are willing to telephone patients individually to ensure the most vulnerable are immunised.
Professor Steve Field, president of the Royal College of GPs, said: “The timing is extremely unhelpful and it will certainly cause disruption.
“There may be some delays in people getting the vaccine, but GPs and patients are pretty resilient and we will find a way.”
In terms of priority, the Government wants doctors to concentrate on immunising the most vulnerable patients, such as those who suffer from diabetes and heart disease, those with damaged immune systems and pregnant women.