Health Secretary Wes Streeting has made what he described as a last-minute offer to England’s resident doctors in an attempt to avert a five-day strike planned to begin next week, as the NHS faces record early-December flu admissions linked to the H3N2 strain.

The revised package, set out in talks with the British Medical Association (BMA), expands training and career support but does not include any additional pay increase, leaving the central dispute unresolved just days before the walkout is due to start on 17 December and run until 22 December.

Streeting said the timing of industrial action would pose a significantly higher risk to patients than previous strikes because it would coincide with the peak of winter pressures. In comments reported by The Independent, he warned that a Christmas-time strike carried “a much different degree of risk” and said he “cannot think of a single other trade union in this country that would behave this way”.

The government’s offer centres on measures designed to ease bottlenecks in medical careers, including a major expansion of specialist training opportunities. Reports of the package suggest it includes around 4,000 additional specialist training posts, along with proposals to reimburse some mandatory exam fees and provide support with certain relocation costs. Ministers have also indicated a stronger focus on prioritising UK-trained doctors for NHS roles, an issue frequently raised by junior and resident doctors who say they face growing competition for training jobs.

Streeting has made clear, however, that he is not prepared to reopen pay negotiations for 2025-26. The government argues resident doctors have already received substantial pay awards since 2023, including a 5.4% uplift for 2025-26, taking cumulative increases to about 28.9% by its calculations. The BMA disputes that this resolves what it describes as long-term real-terms pay erosion and continues to press for “pay restoration”.

On Thursday evening, Streeting said on X that the public would be “appalled” if he implemented the offer while patients still faced pre-Christmas strikes. He said he wanted a “partnership” with the BMA from 2026, but signalled that this would depend on industrial action ending.

The BMA’s resident doctors’ leadership responded cautiously, with deputy chair Dr Shivam Sharma describing the proposals as a “mixed bag”. He said it was “difficult to see members accepting” the offer in its current form, given that it does not move on pay. The union is consulting members on the package, with the process due to close on 15 December, less than 48 hours before the planned start of the strike.

The renewed push to avoid disruption comes as NHS England reported a sharp spike in flu hospitalisations. Data for the first week of December showed an average of 2,660 flu patients in hospital each day in England, up from 1,717 the previous week, a week-on-week rise of 55% and the highest level for this point in the winter on record. At the same stage last year, the comparable figure was 1,861, and in 2023 it was 402.

NHS leaders warned the system was already under acute pressure from multiple fronts, including norovirus and record demand at emergency departments. NHS England said average daily norovirus inpatients were up 35% to about 354, while A&E attendances in November reached 2.35 million and ambulance incidents rose to more than 802,000.

NHS England’s national medical director, Prof Meghana Pandit, described an “unprecedented wave of super flu” and said services were facing a “worst-case scenario” for this time of year. She warned that a resident doctors’ strike on top of surging admissions would push staff “to the limit” in maintaining care.

Prime Minister Sir Keir Starmer backed Streeting’s stance, calling the BMA’s planned action “irresponsible” in broadcast interviews and arguing doctors had already had a “quite significant pay rise”. He indicated the non-pay improvements being offered were conditional on the strikes being called off, particularly in the run-up to Christmas.

Resident doctors, formerly referred to as junior doctors, have been in an on-off industrial dispute since early 2023, arguing that pay has fallen by around a quarter in real terms since the mid-2000s. The strikes have led to repeated disruption to elective care, with health leaders warning that further cancellations during the winter surge could add to existing backlogs.