Thousands of consultants in England are going on strike over pay, with the action expected to cause mass disruption across the NHS.

Consultant doctors and hospital-based dentists will strike for 48 hours from 7am on Thursday morning until 7am on Saturday.

Sir Julian Hartley, chief executive of NHS Providers, which represents health trusts, told the PA news agency: “The impact of this strike on patients and services is likely to be the biggest yet.

“The NHS cannot fully function without consultants.”

Health leaders have warned that planned care will come to a “virtual standstill”, with senior medics providing only emergency Christmas Day-style cover.

Thousands of operations, procedures and appointments have been cancelled and are being rescheduled.

It comes just two days after junior doctors staged a five-day walkout, the longest in the history of the NHS.

More than 24,000 consultants voted in the British Medical Association (BMA) ballot for industrial action last month, with the vast majority (20,741 or 86%) voting in favour.

The Government has told consultants they will receive a 6% pay rise, but the BMA has called this “derisory” and said doctors have seen real-term take-home pay fall by more than a third over the last 14 years.

According to the BMA, consultants on a 2003 contract earn a starting salary of £88,364 in basic pay, rising to £119,133 after around 19 years.

The Department of Health said extra payments such as clinical excellence awards and cash for being on call would take the average NHS pay for consultants in 2023/24 to around £134,000.

NHS trusts have been planning how to manage without their most senior doctors, with Christmas Day cover meaning, in many cases, that consultants will be “on call” throughout Thursday and Friday.

A letter sent to hospital chiefs by the BMA and NHS England earlier this month said care will be provided where there is a risk of serious harm (often called life and limb cover) caused by delaying or deferring procedures due to the strike action.

This care may include urgent or time-critical services such as urgent
palliative and end of life care, dialysis, urgent maternity care, mental health crisis care and critical cancer care, it said.

The letter added that consultant strikes are “different to previous rounds of industrial action” because “no other worker can provide cover for consultants, and other staff groups are dependent upon supervision from consultants to be able to work.

“Almost no activity in a hospital can occur unless it is listed under and supervised by a named consultant.”

Sir Julian told PA that, as the NHS’s most senior doctors, consultants deliver the most complex care and supervise more junior colleagues.

He added: “Eight consecutive months of industrial action is significantly hampering trusts’ efforts to meet vital targets including reducing the waiting list for planned care – now at a record high of 7.47 million.

“The strikes are also eroding staff morale as well as local employment relations between trusts, hospitals and their staff.

“While the Government has recognised doctors and dentists deserve a pay rise, the figure has not been agreed by the relevant union.

“Further strike action can and must be averted. Both sides need to get round the table and find a way to agree on pay uplift that’s fully funded by the Government.”

During the 48-hour strike, the public is being urged to dial 999 for life-threatening emergencies and to contact NHS 111 online for other health concerns.

GP services and pharmacies will be running as normal.

Doctors are expected to line picket lines across England, while a rally will also be held at the BMA headquarters in central London on Thursday afternoon, attended by its consultants’ committee chair Dr Vishal Sharma.

In a statement, Dr Sharma said Health Secretary Steve Barclay had met doctors just once in seven months and had refused further talks on pay.

Analysis also shows consultant pay has fallen way behind the likes of lawyers, architects and financial advisers, the BMA said.

Dr Sharma said: “This dispute is not just about one year’s pay settlement, it is about the reality of 14 years of consultant pay falling behind, about our a loss in our pay in real terms of 35% and the broken pay review system that has allowed this to happen.

“Last week, the Prime Minister described the pay review body’s 6% pay uplift as a ‘significant pay award, one of the most significant we’ve had in decades’ and yet our profession languishes so far behind tens of thousands of other workers in terms of our pay and working conditions.

“Consultants will stand on the picket lines today because we are angry and at rock bottom. We never wanted to be forced into taking this huge step.

“The Government has had seven months to work with us to take our concerns seriously, to listen to us and to find a way to avoid industrial action. Ministers have done absolutely nothing to stop this action taking place.

“We will be on the picket lines today, knowing our pay has flatlined so disastrously, knowing we are undervalued and overworked but also knowing that we remain willing to talk to Steve Barclay as he has the power to halt the strike action by presenting us with a credible offer that we put to our members.”

Mr Barclay said he hugely valued the work of NHS consultants and had accepted independent pay review body recommendations in full to give the medics a 6% pay rise this year, on top of last year’s 4.5% increase.

He added: “This Government has also reformed pension tax rules for consultants, something the BMA campaigned for over many years.

“I am disappointed the BMA is going ahead with this week’s strike, given the average consultant’s NHS earnings are expected to increase to £134,000 a year.

“My door is always open to discuss non-pay issues, but this pay award is final so I urge the BMA to end their strikes immediately.”