The longest strike in the history of the NHS is getting under way as junior doctors take part in a six-day walkout.
Thousands of junior doctors, who make up nearly half the doctor workforce in the NHS, are expected to take part in the stoppage in England from 07:00 GMT.
NHS bosses fear it will bring routine services to a virtual standstill in some areas.
The action follows the breakdown of pay talks last month between the government and British Medical Association.
The BMA says the profession needs to be better-valued.
Ahead of the strike, NHS England medical director Prof Sir Stephen Powis said the NHS was facing one of its most difficult starts to a year since 1948.
Sir Stephen said rising rates of respiratory illnesses, such as Covid and flu, and staff sickness were making this walkout “very challenging” in what is always one of the busiest times of the year for the health service.
Routine hospital services, such as planned operations, like hip and knee replacements and check-ups, will be hugely disrupted.
David Probert, chief executive of University College London Hospitals, said the “vast majority” of routine appointments at his trust would have to be cancelled.
This is because senior doctors are being moved across to provide cover in emergency care.
But even then, not every area is able to keep all its A&E services running.
Last updated: Tuesday 2 January
Data for England is shown by NHS trust, where the trust includes at least one hospital with a Type 1 A&E department. Type 1 means a consultant-led 24 hour A&E service with full resuscitation facilities. Data for Wales and Scotland is shown by Health Board and in Northern Ireland by Health and Social Care Trust.
When you enter a postcode for a location in England you will be shown a list of NHS trusts in your area. They will not necessarily be in order of your closest hospital as some trusts have more than one hospital. Data for Wales and Scotland are shown by NHS board and by Health and Social Care trust in Northern Ireland.
Comparative data is shown for a previous year where available. However, where trusts have merged there is no like-for-like comparison to show. Earlier data is not available for all measures, so comparisons between years are not always possible.
In England and Northern Ireland A&E attendances include all emergency departments in that trust or health board, not just major A&E departments. For example, those who attend minor injury units are included. In Wales the data include all emergency departments, but does not include patients kept in A&E by doctors under special circumstances, [more details here](https://www.bbc.co.uk/news/uk-wales-67056279). In Scotland the data includes only major A&E departments.
Each nation has different target times and definitions for some of the measures shown, therefore comparisons between them are not possible.
A modern browser with JavaScript and a stable internet connection are required to view this interactive.
Cheltenham A&E, for example, will not open, with emergency care provided by the Gloucestershire Royal Hospital, in neighbouring Gloucester, which is run by the same NHS trust.
There is particular concern among NHS bosses about some urgent areas of cancer care and maternity services, such as emergency caesareans.
An appeal by NHS Employers, which represents hospitals, for a strike exemption for urgent cases in these areas was rejected by the BMA.
NHS England is advising patients in a life-threatening emergency to call 999 as usual, but for everything else to use 111.
Patients who have routine appointments should attend as normal unless they have been told not to.
There is also expected to be some disruption to GP services.
Paul Farmer, of Age UK, said the timing of this set of strikes was particularly “alarming”.
“We are deeply concerned about the risk this poses to older people’s health – it will be difficult to guarantee safe and effective care for everyone who needs it.”
Junior doctors have taken part in 28 days of strike action in their pay dispute. The first walkout was in March last year.
Before that, other NHS staff, including nurses and ambulance staff, were involved in strike action.
Over the past year more than 1.2 million appointments and treatments have had to be cancelled because of industrial action.
The walkouts by doctors, which has also included consultants, has been by far the most disruptive.
Strike action in the NHS is also estimated to have cost more than £2bn in planning, preparations and paying for cover.
Nigel Hewitt, 54, from Peterborough, had an operation cancelled due to the junior doctor strikes in December.
He was due to undergo his seventh – and what he hoped was his last – operation on an abscess affecting his bowel.
He has a wound which needs to be cleaned and changed regularly, so it limits what he can do.
“It does stop me doing things and I’ve had enough, really. I was hoping this would have been the final one, so it is very frustrating.
“But I do have sympathy for junior doctors. We need to attract people to work in the NHS, so we have got to have a pay and reward system that recognises their roles and responsibilities.”
Strike action was suspended in October to allow pay talks to take place between the government and the BMA.
But the BMA ended those talks after its deadline of early December passed without a resolution.
An offer of a pay rise averaging 3%, from January, was being discussed, which would have been on top of the average of nearly 9% junior doctors received in April.
But the BMA said that was too little – junior doctors had asked for an extra 35%, to make up for below-inflation pay rises since 2008.
Health Secretary Victoria Atkins said junior doctors should call off their strike and “come back to the negotiating table so we can find a fair and reasonable solution to end the strikes once and for all”.
BMA junior doctors committee co-chairmen Dr Robert Laurenson and Dr Vivek Trivedi said the government needed to come forward with a “credible offer”.
“Doctors would have liked to start the new year with the hope of an offer on pay that would lead to a better-staffed health service and a better-valued profession.”
Back in May, NHS staff other than doctors accepted a pay offer of 5% extra, plus a one-off lump sum, while strike action by consultants has been put on hold as they vote on a fresh offer from the government.
In Wales, junior doctors are due to take part in strike action later in January, while in Northern Ireland they are being balloted over action.
In August, a pay deal was reached with junior doctors in Scotland. It includes a 12.4% pay increase for 2023/24, in addition to a wage rise of 4.5% for 2022/23 with ministers also promising talks on future pay increases.
Are you a junior doctor with a view on the strike? Are you a patient affected? Email haveyoursay@bbc.co.uk.
Please include a contact number if you are willing to speak to a BBC journalist. You can also get in touch in the following ways:
If you are reading this page and can’t see the form you will need to visit the mobile version of the BBC website to submit your question or comment or you can email us at HaveYourSay@bbc.co.uk. Please include your name, age and location with any submission.
Sign up for our morning newsletter and get BBC News in your inbox.
Fresh pay offer could end NHS consultant strikes
Nurses react with fury over doctor pay offer
What is the NHS pay offer?
Why talk of a UK doctor exodus is premature
NHS pay deal signed off for one million staff
Some NHS temporary staff miss out on full pay deal
How much do junior doctors really get paid?
Statistics ? Consultant-led Referral to Treatment Waiting Times Data 2023-24.website
Lenders cut mortgage rates to ease borrowers’ pain
Man killed by falling tree as Storm Henk disruption continues
London Eye passenger describes hatch scare in storm
Chart queens – seven of year’s biggest singles were by women
Pupils at crumbling concrete schools ‘kissing top grades goodbye’
Luke Littler – the 16-year-old who is changing darts
The young singers killed by a Russian rocket
In pictures: Nordic states gripped by winter freeze
How Storm Henk and other UK storms get their names
Sound of 2024: Peggy Gou breaks out of the dance bubble
‘South Asian clothes can live more than one life’
Thai balcony fall survivor vows to walk again
Can you tackle an exam paper from 1960?
We’ve selected a handful of questions from across six different exam papers…
A whole new term of chaos is about to begin…
Watch the new series of Waterloo Road, now on BBC iPlayer
‘Dancing in the Dark was written under duress’
Stories of what Bruce Springsteen’s iconic song means to people around the world
Is it time to make your will?
Martin Lewis talks wills, power of attorney and tips to get the best service from call centres
The explosive return of Vigil. VideoThe explosive return of Vigil
Five Welshmen face up to their secrets. VideoFive Welshmen face up to their secrets
Running from a past he can’t remember. VideoRunning from a past he can’t remember
A land steeped in myth… VideoA land steeped in myth…
© 2024 BBC. The BBC is not responsible for the content of external sites. Read about our approach to external linking.
