Resident doctors in England have rejected the British government’s latest offer aimed at ending their long-running dispute over pay and working conditions, paving the way for a five-day strike to begin on Wednesday and intensify pressure on the National Health Service during a severe winter surge.
The British Medical Association (BMA), which represents resident doctors — the group previously known as junior doctors — said members voted against the package, which contained no additional pay this year or next and focused instead on measures linked to training and professional costs. The decision means the planned walkout from Wednesday 17 December to Monday 22 December will go ahead, covering the final working week before Christmas.
The BMA’s resident doctors committee said “tens of thousands” of frontline doctors had rejected the proposal and argued that action remained avoidable if the government returned with an improved offer in the remaining time before the strike begins.
The government’s offer, announced in recent days in a last attempt to avert industrial action, centred on expanding specialty training opportunities and reducing out-of-pocket expenses for doctors. Measures included additional specialty training posts over coming years and commitments that the NHS would cover certain exam fees and professional membership subscriptions. Ministers have repeatedly ruled out reopening pay talks as part of the latest negotiations.
Media reports said the rejection was decisive. The Financial Times reported that about 83% of participating members voted against the deal on a turnout of roughly 65%, though the BMA has not publicly released a full breakdown in its initial statement.
Prime Minister Keir Starmer criticised the decision to strike as the NHS faces escalating demand and rising hospital admissions for influenza. In recent remarks, Starmer said the action was “beyond belief” given the state of winter pressures, while also stressing that he supports the right to strike in principle.
Health Secretary Wes Streeting has argued that resident doctors have already received substantial increases since the dispute began, citing a near 29% pay rise over the past three years, and has said there is no further fiscal room for additional pay awards. He has framed the government’s non-pay package as an attempt to address career progression bottlenecks and improve take-home pay indirectly by removing fees.
The strike will add to disruption across hospitals and some community services in England, where resident doctors make up a large share of the medical workforce and are central to day-to-day staffing. NHS leaders and hospital managers are expected to cancel and reschedule elective operations and outpatient appointments, while trying to maintain urgent and emergency care through consultant cover and other contingency arrangements.
The timing coincides with heightened concern about winter resilience. NHS England has warned of a “worst-case scenario” December, with hospitals facing high bed occupancy and increased A&E attendances. Recent data cited by health leaders showed flu admissions rising sharply, with an average of about 2,660 patients a day in hospital with influenza in early December, up about 55% on the previous week. Several trusts have already reported severe strain, with some declaring critical incidents earlier in the season.
The resident doctors’ dispute dates back to March 2023 and has become one of the most persistent industrial conflicts in the public sector. Doctors argue their earnings have fallen substantially in real terms since 2008 and are seeking a multi-year path to restore pay, while the government says the scale of additional increases demanded would be unaffordable and risk wider knock-on effects.
Alongside pay, the BMA has focused on what it describes as a “jobs crisis” for early-career doctors, pointing to intense competition for specialty training places and warning that many qualified doctors are unable to progress. The government’s offer attempted to address that pressure through additional training posts and planned reforms, but the union said the proposals did not go far enough and did not resolve the core pay dispute.
Previous strikes have already had a substantial impact on NHS activity. Government figures have put earlier cancellations and rescheduling in the hundreds of thousands, while health service leaders have warned that repeated walkouts deepen backlogs and add financial costs for trusts already under strain.
The BMA has said emergency cover will be maintained and that patient safety will be prioritised during the walkout. The NHS typically advises patients to attend scheduled appointments unless contacted to say they have been cancelled, though disruption can vary by trust depending on local staffing and pressures.
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