The British Medical Association says England’s consultants will stop planned work for 48 hours from 25 November unless the Health Secretary agrees to formal negotiations. Ministers say talks are already under way and put the cost of the union’s hours demand at over £2bn.
Senior hospital doctors in England will strike from 06:59 on 25 November to 06:59 on 27 November, the British Medical Association (BMA) announced on 26 October, unless the government moves first.1 Only emergency cover will run, as on Christmas Day. Planned work that needs a consultant would be hit. It would be the first consultant strike since 2023.1
The BMA says the strike is avoidable. It wants the Health Secretary to commit to formal, funded negotiations on pay and working conditions. The government, which has four weeks, says it is already talking.18 The two sides disagree about whether that counts as negotiation, and about what the dispute costs.
The union holds a legal mandate that runs for 12 months from the ballot that closed on 6 July.2 That mandate was narrow in one way: turnout cleared the 50% threshold by only about 500 votes.
The BMA’s case has two parts. The first is pay: it says consultants have had a 25% real-terms cut over 17 years.1 That is the union’s own calculation. The second is time. It wants a shorter standard week, more protected time for teaching and improving services, and better recognition for the hardest out-of-hours work.1
The pay review body recommended a 3.5% rise for 2026/27, effective from 1 April.5 The BMA says the government has told the same body it would offer only 2.4% for 2027/28, which the union calls a real-terms cut on any measure of inflation.1 Resident doctors accepted a deal in June that ended their strikes, which leaves consultants as the main remaining group in dispute.9
The Nuffield Trust, an independent health think tank, gives the other side of the pay picture. Consultant pay scales have started to rise in real terms since 2023 after about a decade of falls, and basic salaries in 2025/26 ran from £109,725 to £145,478. Average total NHS earnings for full-time consultants were about £161,600.6 Both readings can hold at once: a long fall, then a recent recovery that the union says is not enough.
Health Secretary Yvette Cooper called the announcement disappointing and urged doctors not to take “irresponsible action that would place our health service under even greater pressure”, as winter nears.8 An unnamed Department of Health and Social Care source told reporters the BMA wants five hours off the working week, at a cost of “over £2bn”, and said consultants’ earnings are up £25,000 over four years.9 That figure has not been published with its workings.
Ministers have “kicked the can down the road”, its consultants’ co-chairs said on 26 October, and talks so far have not been formal negotiations.1
NHS Employers urged the BMA to “get back around the table and talk”, and said the NHS must be open about what it can afford.3
On the ballot, the department’s counter-point is arithmetic: about 39% of eligible consultants voted yes.2 That is correct, and so is the BMA’s 76% of those who voted. The law sets the threshold at turnout, which was met.
Patients feel a consultant strike through cancelled operations and clinics, because many planned procedures need a consultant present or supervising. NHS England counted 65,557 inpatient and outpatient appointments and procedures rescheduled in the first two-day consultant strike, in July 2023, and said that was probably an undercount because some trusts did not report.4
The backdrop is different now but not easier. NHS England’s August figures show 7.37 million treatments waiting and 65.2% of patients waiting under 18 weeks, against a 92% standard; the list was up 0.6% on July.7 The 2023 count equalled about 0.9% of today’s list. A rescheduled appointment is delayed, not lost, but each one adds to a queue that is not falling. NHS Alliance leaders said they were dismayed by the decision.9
The strike would also fall in the week before the winter peak that ministers have said they are preparing for, when beds and staff are already stretched.8
Formal strike notices have not yet been issued, and reports differ on whether the action is two calendar days or 48 hours; the BMA’s own notice says 06:59 on 25 November to 06:59 on 27 November. The government has not published the workings behind its £2bn figure, and the 2.4% figure for 2027/28 is the BMA’s account of evidence to the review body.
The BMA says the strike is off if the Health Secretary commits to funded, formal negotiations on pay and conditions, and the government has until the strike starts on 25 November to answer.1 Formal notices to employers are still to be issued. If the strike goes ahead, NHS England publishes counts of rescheduled appointments after each action, so the cost will be measured against the 2023 figure. In Scotland, a separate ballot of consultants and specialty doctors opened on 26 October.1