Why are junior doctors striking and how will the NHS cope?

The four-day walkout is said to be the most disruptive in the history of the health service

Some 50,000 junior doctors in England have downed their stethoscopes and picked up placards as they stage a four-day walkout in the bitter dispute with the government over pay.

Here are answers to some of the key questions on the strike action.

Why are junior doctors striking?

The strikes centre on a pay row between the British Medical Association and government, with the union claiming junior doctors in England have seen a 26 per cent real-terms pay cut since 2008-09 because pay rises have been below inflation.

The union has asked for a full pay restoration that the government said would amount to a 35 per cent rise – which ministers have said is unaffordable.

How much are junior doctors actually paid?

The term “junior doctor” is a bit misleading because it covers all doctors under consultant level. Some doctors could have been working in the NHS for almost a decade but still be referred to as a junior.

They are paid different wages depending on their level of experience.

Those with the least experience – known as a Foundation Year 1 (FY1) doctor – are paid a basic rate of £14.09 per hour – or £29,384 a year.

But it is very unlikely a doctor will only get this much because they receive additional payments for overnight and weekend work. These additional payments also increase with experience.

The most senior junior doctors have a starting salary of £58,398, plus the additional payments.

When is the action taking place?

The strike started at 7am on Tuesday and will continue until 7am on Saturday.

What has the NHS said?

The health service says emergency care will be prioritised during the strike action – this includes services such as A&E, critical care, maternity services and neonatal care.

The most senior NHS doctors, consultants, and other staff in the NHS who are not on strike will be diverted to cover these areas, which will mean their usual work will not go ahead so appointments and operations will be postponed.

What do I do if I’m sick?

People are advised by the NHS to access the care they need in the usual way – only using 999 and A&E in life-threatening emergencies and using NHS 111 online and other services for non-urgent health needs.

The NHS said pharmacies and GPs are largely unaffected by the strikes so patients can still get appointments and health advice.

What impact will the strike have?

This is the second strike in the current dispute. The last walkout lasted for three days and around 175,000 appointments and operations were postponed as a result.

NHS officials believe the latest strike will lead to “considerably more” appointments being rescheduled – some have estimated the four-day action could lead to 350,000 appointments or operations being postponed.

But there will be some patients hidden in the figures – for instance a patient who broke their hip over the Easter bank holiday weekend who will not get their restorative surgery until next week but will be forced to stay in a hospital bed until then or “risk losing their place”; or a newly diagnosed cancer patient who should have started weekly chemotherapy the week before the strikes but was not started on treatment to ensure continuity.

Why will this strike have more impact when it only lasts a day longer than the last one?

The 96-hour strike is likely to be the most disruptive in the history of the NHS due to the length of the strike and the fact that doctors have chosen to take action directly after a long bank holiday weekend – which traditionally causes disruption to the NHS even without the prospect of strike action.

The walkout also coincides with the Easter school holidays, which means many consultant staff who provided cover during the first round of strikes will be unable to do so again due to pre-planned holidays and childcare commitments.

Will junior doctors leave the picket line for emergencies, like paramedics did during recent ambulance service strikes?

Probably not. The BMA has agreed it will suspend action if there is a mass casualty event or if NHS trusts are overwhelmed and need to call in extra support.

This can only be done if a hospital trust leader contacts an NHS England incident team, which will then pass the details to the BMA. The union will then decide whether the incident can only be mitigated by junior doctors returning to work.

The BMA has said it will also have to post on Twitter it has agreed these so-called derogations so “it is easy for members to verify it”.

Is the public supportive of strike action?

A new poll by Ipsos found more than half (54 per cent) of Britons support the strike, while 49% of the 1,092 British adults polled think junior doctors are paid too little.