A looming fresh wave of strikes by resident doctors could encourage other NHS staff including nurses to take industrial action over pay, health service bosses fear.
Resident doctors, formerly junior doctors, in England are threatening to stage stoppages until January in pursuit of their demand for a 29% pay rise, after 90% voted in favour in a ballot on a 55% turnout.
The strikes will bring renewed disruption to the NHS, which has not faced a national strike by any staff since the last of the 11 walkouts by junior doctors ended on 2 July last year, just before Labour won power.
The health secretary, Wes Streeting, and the British Medical Association (BMA) are at loggerheads over the strikes, which NHS chiefs say could lead to hundreds of thousands of appointments and operations being cancelled.
Face-to-face talks on Tuesday afternoon left the gulf between them as wide as ever.
The BMA urged Streeting to “immediately negotiate a new pay deal” to replace the 5.4% rise he has awarded for 2025-26, but he is adamant that he will not reopen negotiations and stressed that the government is unable to afford to be more generous.
Dr Melissa Ryan and Dr Ross Nieuwoudt, the co-chairs of the BMA’s resident doctors committee, said: “Doctors have spoken and spoken clearly. 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.”
Streeting needed to outline “a credible path to pay restoration”, they said, making up the significant loss in the real-terms value of their salaries over the last 16 years.
Streeting said it was “disappointing that the BMA are threatening strike action that would harm patients and set back all the progress we’re making with the NHS”.
He urged the union to think again and emphasised that resident doctors’ pay had risen by 28.9% over the last three years, in large part thanks to the 22% he gave them last year – for 2023/24 and 2024/25 – after they went on strike on 44 days under the previous Conservative administration.
Other unions are already exploring the possibility of striking in order to get higher pay than their awards for this year.
The chief executive of the NHS Confederation, Matthew Taylor, highlighted “the risk that these strikes heighten tensions within different staffing groups, with nurses and other staff also discussing industrial action”.
He also said strikes by resident doctors would imperil the delivery of the government’s key NHS pledge to voters – to restore the target that 92% of people waiting for planned hospital care get it within 18 weeks by 2029.
The Royal College of Nursing and Unison – whose members were given 3.6% – are undertaking indicative ballots of their members to assess their willingness to strike.
The RCN’s general secretary and chief executive, Prof Nicola Ranger, said: “Nursing staff are similarly voting in strong numbers and telling the government to go faster in repairing a damaged NHS and undervalued workforce.
“Avoiding strikes by talking, negotiating and planning together is the only sensible route open to ministers.”
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The chief executive of NHS Employers, Danny Mortimer, called the prospect of doctor strikes “a troubling development” and “the last thing health leaders wanted”. Patients would be left in pain and discomfort, he said.
The Department of Health and Social Care (DHSC) said that “strikes will have extremely serious consequences for patients. They should only ever be a last resort”.
Whitehall sources pointed out that the 55% turnout in the resident doctors’ ballot was lower than previous two ballots.
Its result, however, means the NHS could face coordinated strikes by resident doctors and hospital consultants in the autumn. The latter are threatening to strike over the 4% pay rise they were awarded for this year, which the BMA called “an insult to senior doctors”.
It is launching an indicative ballot of its consultant members in England on 21 July to explore their willingness to stage walkouts in pursuit of a higher salary increase.
The BMA criticised the 5.4% award resident doctors were given in May as “woefully inadequate” and “derisory”. It has made clear that resident doctors wanted their salaries increased by 29% over the next few years to make up for the erosion in their value since 2010. But it has stressed that they are seeking the 29% rise over several years and not for 2025-26 alone.
A DHSC source highlighted that just under half of all resident doctors balloted had voted to strike. It said: “On a turnout of 55.32%, with 90.05% in favour, that means only 49.78% voted in favour of strike action.”
The potential strikes pose a serious problem for Streeting. If he increases the 5.4% rise he awarded resident doctors in May, other NHS staff groups such as the RCN may press for higher amounts too.
But if he does not budge, then resident doctors are likely to keep striking until they secure a higher award, as they did in 2023 and 2024. The tough public finances situation the government faces means he has limited room for manoeuvre, especially given that 1.5 million people work for the NHS in England, so any increase on sums already announced would be very expensive.