Hospital consultants are gearing up to join resident doctors in striking over pay in a move that could cause huge disruption for the NHS and present ministers with a major new headache.
In addition, resident doctors – who will tomorrow embark on their latest strike – have decided to adopt a more militant approach in pursuit of their 26% pay claim in which they strike every month, to put pressure on the government.
In a hardening of their tactics, resident – formerly junior – doctors will stage a walkout every month in 2026 if, as they expect, they get a fresh legal mandate to continue their long-running campaign of industrial action. They went on strike 11 times in 15 months between March 2023 and June 2024 but only once since, in July this year.
Thousands of them will take part in what will be the 13th strike of their campaign, starting at 7am on Friday and running until 7am on Wednesday 19 November.
Consultants now look likely to add to ministers’ already acute difficulties over NHS pay, the Guardian can reveal. The British Medical Association’s consultants committee has been in talks since September with the Department of Health and Social Care (DHSC) about its demand for more than the 4% rise imposed on them for 2025/26. They believe their salaries should rise this year by 5.5% – a further 1.5% – given the importance of their work.
But the consultants committee is frustrated at what BMA sources say is the lack of progress. They have given Wes Streeting, the health secretary, a deadline of 31 December to reach a deal for more money. Unless agreement is reached by then it plans to hold a ballot for industrial action in January and – if it gets the 50% turnout and 50% agreement required in law – start striking soon after.
Strikes during the first half of 2026 by both the NHS’s main groups of medics in England would cause havoc and derail the government’s totemic pledge to “fix the NHS” by cutting treatment delays.
One NHS leader warned that a potential series of walkouts by consultants – senior doctors – would be “a bitter pill” for already-embattled health service staff to swallow, especially during the winter.
One BMA insider said: “The consultants committee has given its negotiators until 31 December to negotiate with Wes Streeting and his team for meaningful changes to consultant pay. I don’t think that’s going to be meaningful. So we’ll be balloting in the new year. We’ll be gearing up, potentially towards industrial action in the new year.”
Two-thirds of consultants have already indicated their willingness to strike in pursuit of better pay, although that was in a purely indicative ballot in which turnout was below 50%. They claim that the real terms value of their pay has been eroded by 26% since 2008/09 as a result of inflation and years of low annual pay settlements.
Almost all the 69 voting members of the BMA’s resident doctors committee (RDC) back switching to the more hardline approach of monthly strikes, which may also involve longer walkouts – the previous longest was six days in January 2024 – union insiders say.
The BMA’s ruling council has already approved a request from Dr Jack Fletcher, the RDC’s chair, for it to reballot its 60,000 resident members when its current mandate expires on 6 January. If successful, resident doctors could strike as often as they decide for six months.
“Consultants voting to down tools would be a bitter pill to swallow for NHS staff who are working hard to recover performance and reform services. More strikes over winter would cause huge disruption to patient care during the busiest period of the year for the NHS,” said Matthew Taylor, chief executive of the NHS Confederation.
“Further strikes would jeopardise the good progress being made in cutting waiting lists and would divert more money from what are already very stretched budgets. We urge the BMA to avoid any further strike action, especially during the winter months.”
Strikes since 2022 by doctors, nurses, ambulance crews, radiographers and other NHS staff have forced the NHS in England to reschedule at least 1.7m outpatient appointments and operations.
Helen Morgan, the Liberal Democrat spokesperson on health and social care, said: “This is hugely worrying for patients who are suffering historic waiting lists and deteriorating care – and now face yet more disruption.”
A double whammy of doctor strikes would be a serious setback for Streeting. He this week bitterly attacked the union over the resident doctors’ strike campaign, accusing the BMA of acting like a “cartel”, being a threat to the NHS’s future and pushing unreasonable demands. More strikes would undermine his promise to ensure patients once again get planned hospital treatment within 18 weeks by the end of this parliament in 2029. The waiting-list fell slightly in September to 7.39m, involving 6.24m patients, NHS figures published on Thursday showed.
He highlighted that resident doctors have seen their pay rise by 28.9% since 2022 and he came close to accusing them of being greedy in a speech to a gathering of NHS bosses. Consultants earn £127,540 on average while resident doctors’ basic pay, before overtime, ranges from £38,831 to £73,992.
The BMA made clear its view that all types of doctors, not just residents, deserve to have the value of their salaries restored. “The BMA is led by our 200,000-strong members who set policy and the council of elected members advises and supports the implementation of these policies.
“Campaigning for full pay restoration for all doctors is such a policy,” a spokesperson said.
Consultants will not go on strike, the DHSC said.
“The BMA’s indicative ballot showed that the vast majority of their consultants aren’t prepared to go on strike, and rightly so,” a spokesperson said.
“As a highly valued part of the NHS workforce, new full-time consultants have seen their basic pay increase by 24% over the past three years, with an average salary of £145,000 a year. For the first time in over a decade, the NHS is finally on the road to recovery. NHS doctors now have a government that values them and wants to work with them to enhance their working conditions and rebuild our NHS.”
