Doctors in England and Wales go on strike for five days from Friday, with warnings it could lead to patient harm in emergency departments.
It is the culmination of an escalating row between NHS bosses and the British Medication Association (BMA) over pay.
Here is everything you need to know about the strikes.
How long is the strike?
From 7am on Friday 25 July to 7am on Wednesday 30 July.
Who is striking?
Up to 50,000 resident doctors will walk out.
Resident doctors is the new name for junior doctors – it was changed to better reflect their responsibilities. Resident doctors are fully qualified doctors who are either currently in postgraduate training or gaining experience as locally employed doctors to become consultants, GPs or specialists.
Their title was changed after years of calls for the term “junior” to be retired, as it was seen as both misleading and demeaning.
General practice, community pharmacies, and dentistry are not impacted by the action.
How will it affect appointments?
During previous strikes, NHS England told trusts to cancel large volumes of non-urgent care so that consultants could step in to cover emergency care.
Previous rounds of industrial action – 11 walkouts over multiple days – saw an estimated 1.5 million appointments cancelled or rescheduled.
But under the leadership of new NHS England chief executive Sir Jim Mackey, hospitals have now been instructed to cancel non-urgent work only in “exceptional circumstances” – and only with prior approval.
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This suggests that much fewer planned appointments will be cancelled, although no exact figures have been given by either side.
The BMA has warned this new approach risks spreading doctors too thinly.
How will I know if my appointment has been cancelled?
Patients have been advised to “choose healthcare wisely” during the strike.
If your appointment has been cancelled, or rearranged, you will be contacted by the hospital directly. Priority will be given to patients with the most pressing health needs.
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If you do not hear that your appointment has been changed, you should attend as usual.
Will I still be able to access emergency care?
If you need emergency care during the strike you should still go to hospital as normal.
Patients have been told to call 999 if it is a medical or mental health emergency.
If the situation is non-life threatening, patients should seek support through NHS 111, NHS 111 online, their GP or a pharmacy.
Why are they striking?
Doctors in England and Wales were awarded a 5.4% pay increase by the government, but the BMA still threatened strike action, claiming the increases did not account for historical pay freezes.
Instead the BMA is calling for a rise of 29.2% to bring salaries back in line with 2008 levels.
More than 26,000 resident doctors voted in favour of the strikes.
I thought they already had a pay rise?
Yes, in July last year resident doctors were awarded a raise of 22% over two years, bringing to end months of strike action. It was the highest public sector award in recent years.
But the trade union argues that pay has declined significantly since 2008 when adjusting for inflation. The latest deal saw doctors given a 4% increase, plus £750 “on a consolidated basis” – which works out as an average rise of 5.4%.
The BMA said no doctor “took the possibility of striking lightly” but the majority of its members believed they had “no other choice”.
“Doctors have spoken and spoken clearly,” the union said.
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“They won’t accept that they are worth a fifth less than they were in 2008. Our pay may have declined but our will to fight remains strong.”
The BMA said Mr Streeting had the power to “make the right decision” on pay.
Does the public support the strikes?
A new YouGov poll found support for the strikes is declining.
The survey found about half (52%) of people in the UK either “somewhat oppose” (20%) or “strongly oppose” (32%) the idea of resident doctors going on strike over pay.
Older people are more likely to be against, with 52% of those aged over 65 “strongly opposed”, compared to 10% of those aged 18 to 24.
YouGov says the proportion of people who support the strikes has dropped five percentage points since May last year.
What does the government say?
Talks between the government and BMA have continued, with the latter saying strikes could still be avoided.
Health secretary Wes Streeting has ruled out any additional pay rises this year, but has said other aspects of the contract – including student debt, exam fees and working conditions – may be up for negotiation.
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Mr Streeting previously warned the BMA the public “will not forgive” strike action.
He wrote in The Times that any walkouts would be a “disaster” for the union and for patients, adding the government “can’t afford” more pay rises.
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NHS chiefs said any return to industrial action would be “bad for patients, for staff and for the NHS”.
Chief executive of NHS Providers Daniel Elkeles said: “We need cool heads to de-escalate this and remove the threat of further damaging industrial action.”
