Resident doctors across England began a five-day strike on Wednesday in the latest escalation of a dispute with the government over pay, job security and training opportunities, with health leaders warning the action will intensify pressure on hospitals during a winter flu surge.
The walkout started at 7am on 17 December and is due to run until 7am on 22 December, affecting NHS hospitals and some community services. NHS England said disruption and delays were expected, with trusts likely to postpone non-urgent care to prioritise emergency treatment and services for the most seriously ill patients.
The British Medical Association (BMA), which represents resident doctors (previously known as junior doctors), said the strike is part of a long-running campaign against what it describes as sustained real-terms pay erosion and a “preventable jobs crisis” in the medical workforce. It said resident doctors have seen pay fall in real terms since 2008 and argues that restoring pay to 2008 levels would require an increase of roughly 26% to 29%.
The government disputes the scale of any further increase it can offer, saying resident doctors have already received significant rises. Health Secretary Wes Streeting has previously said doctors have had an average pay rise of about 28.9% over three years, including increases delivered under Labour, and that there is limited room for additional spending.
Streeting criticised the decision to strike during winter pressures, with hospitals reporting higher demand linked to respiratory illness. Speaking ahead of the walkout, he said the action showed a “shocking disregard for patient safety” at a time when the NHS is under strain.
NHS England also warned that the impact could be greater than during some previous rounds of industrial action because of current levels of flu and winter admissions. Data reported this week indicate flu-related hospital admissions have risen sharply in December, with some measures more than 50% higher than early-month averages, adding to existing pressure from seasonal illness and waiting list backlogs.
The strike is the 14th round of action by resident doctors since March 2023. Previous stoppages have led to tens of thousands of cancelled appointments and procedures, with knock-on effects for patient waiting times and hospital finances. Trusts have repeatedly urged the public to continue attending emergency departments when needed while also using NHS 111, GPs and pharmacies where appropriate.
Talks between the BMA and the government have not produced a settlement. Recent discussions collapsed after doctors rejected an offer that focused on non-pay issues, including training posts and fee reimbursements, according to reports. The BMA says pay remains central but has also highlighted concerns about career progression and the availability of specialty training places.
One of the key issues raised by doctors is what they describe as a growing bottleneck in training and progression. Reports have pointed to more than 30,000 doctors competing for around 10,000 specialty training places, increasing uncertainty for doctors trying to secure posts required to advance their careers. The BMA says this has created an escalating retention problem, with doctors considering leaving the NHS or moving abroad for better pay and clearer progression.
Dr Jack Fletcher, chair of the BMA Resident Doctors Committee, said the strike was a stand against a “preventable jobs crisis” and continued real-terms pay cuts. The union argues that without a credible offer on pay and a plan to address training and staffing gaps, the NHS will continue to struggle to recruit and retain doctors.
Downing Street has also criticised the timing of the action. Prime Minister Sir Keir Starmer has said strikes risk harming patients and adding to disruption in the health service during a peak period, while the government has insisted it remains willing to talk but must operate within fiscal constraints.
Hospitals have activated contingency plans similar to those used during earlier strikes, including redeploying senior doctors and prioritising urgent and emergency care. Patients are being advised to expect delays for routine appointments and elective procedures, and to check local NHS guidance if they are due to attend non-urgent services during the strike period.
Further negotiations could still take place while the walkout continues, but neither side has indicated a breakthrough is imminent. The scale of cancellations and the effect on waiting lists are expected to become clearer over the coming days as trusts report disruption levels across England.
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