Doctors are threatening a six-day strike in England, deepening a bitter dispute with the government over pay and jobs that now risks engulfing the entire hospital medical workforce.
The British Medical Association has confirmed that resident doctors will walk out from 7am on Tuesday 7 April until 6.59am on Monday 13 April, a move NHS bosses fear will cause severe disruption during the Easter school holidays. This will be the 15th such strike since March 2023.
Ultimatum and accusation
The strike announcement comes after the BMA’s resident doctors committee rejected the government’s “final offer”, leading Prime Minister Keir Starmer to issue a 48-hour ultimatum for the union to accept. The deadline expires today, Thursday.
In a sharp escalation of rhetoric, the BMA has directly accused the Prime Minister and Health Secretary Wes Streeting of sabotaging the prospects of a deal. Dr Jack Fletcher, chair of the BMA’s resident doctors committee, wrote to the health secretary claiming that “political rhetoric – threatening to remove training places – coupled with the way the government has communicated the offer, has needlessly and avoidably inflamed the dispute, ultimately pushing the chance of a deal further away.”
The union argues that a “final offer followed by threats that parts of the offer may be withdrawn is not the way to end this dispute.” Dr Fletcher also accused the government of having “shifted the goalposts on the deal at the last minute” by altering the pay offer and stretching it over a longer period.
At the heart of the BMA’s rejection is a demand for “full pay restoration” to 2008 levels, which it calculates requires a 26% pay rise. The union states resident doctors have seen their pay fall by 20% in real terms since 2008, and disputes the government’s claim that its offer would leave them on average 35.2% better off than four years ago, calling that figure a wild overstatement when inflation is factored in.
The 1,000 training jobs at stake
The most contentious element of the standoff is the government’s explicit threat to scrap 1,000 new specialist training posts for medics if the strike proceeds. This threat forms the core of the Prime Minister’s ultimatum.
The government’s rejected offer included a pledge to increase specialist medical training places by up to 4,500 over the next three years. Crucially, 1,000 of these new posts were due to be filled from this August, offering a vital career progression step for early-career doctors.
Health Secretary Wes Streeting has told the BMA that these 1,000 extra slots will be withdrawn unless the deal is accepted, stating plainly: “Those jobs will not materialise if the BMA rejects this deal, I am afraid.” He claimed the places had been secured through “persuading and arm twisting” of NHS trusts. Prime Minister Starmer reinforced this in an article for the Times, warning the BMA would be “reckless” to walk away from the deal.
The move has heightened fears among resident doctors about their career progression. There appears to be some confusion over the status of the posts, with NHS England recruitment channels reportedly still indicating they will open in April, while the Department of Health and Social Care states they will not proceed without a deal.
The BMA views the threat as political manoeuvring, arguing that “creating posts and improving patient care should not be dependent on calling off a strike.”
Government response and widening dispute
A spokesperson for the Department of Health and Social Care expressed disappointment at the strike proceeding. “Because the BMA resident doctors committee has not agreed to call off these strikes and put an offer to members, we will now not be able to deliver the 1,000 extra training places which the BMA asked for,” the spokesperson stated.
The DHSC reiterated that its offer included a pay rise of up to 7.1% for this year, reforms to pay progression, and exam fee reimbursements. It also highlighted that, under the deal, starting pay for new graduates would have been nearly £12,000 higher than in the 2022-23 financial year.
Separately, the dispute is spreading rapidly across the medical profession. The BMA has opened a new front by deciding to ballot consultants and specialist, associate specialist, and specialty (SAS) doctors for industrial action over what they deem an “inadequate” pay award of 3.5% for 2026-27. This award, recommended by the Doctors’ and Dentists’ Pay Review Body, is below the RPI inflation rate of 3.6% for the 12 months to February 2026.
The union states consultants’ pay is 26% lower in real terms than in 2008/09, with SAS doctors’ pay down 24% over the same period. GPs in England have also rejected government-imposed changes to their contract. If the consultant and SAS doctor ballots succeed, all major groups of hospital doctors in England could be in simultaneous dispute with the government, raising the spectre of coordinated strikes.
The financial and operational toll of the ongoing action is heavy. Previous strikes have led to an estimated 1.7 million healthcare appointments being rescheduled since the end of 2022, with each strike day estimated to cost the NHS up to £300 million.
