Hospitals in England are facing major disruption as junior doctors have gone on strike in a dispute with the government over a new contract.
The doctors are providing emergency cover only during the 24-hour walkout, which got under way at 08:00 GMT.
The NHS has so far postponed 4,000 routine treatments – about one in 10 planned – including knee and hip ops.
A West Midlands hospital has also asked doctors to come off the picket line to help after a surge in patients.
Bosses at Sandwell raised the alarm shortly after the strike got under way, saying beds were filling up and they were struggling to discharge patients. But the British Medical Association has so far refused to agree to the request, arguing it is not clear whether it qualifies as a major incident.
The strike has gone ahead despite a last minute plea from Prime Minister David Cameron for doctors to call off the action, warning it would cause “real difficulties for patients and potentially worse”.
The walkout comes after talks between the union and government failed to reach agreement on the contract. The BMA is concerned about pay for weekend working, career progression and safeguards to protect doctors from being over-worked.
But ministers have argued the current arrangements are outdated and changes needed to improve standards of care at the weekend.
In preparation for the action, hospital bosses across the country had:
- postponed 4,000 routine treatments, such as knee and hip replacements, some of which are on the days before and after the walkout
- cancelled many more appointments, check-ups and tests
- prioritised cancer care to minimise the risk to those needing vital surgery and treatment
- told patients to use alternatives to hospital where possible, such as pharmacies, NHS 111 and GPs, on the day of the strike
- been told by NHS England medical director Prof Sir Bruce Keogh that striking doctors can be called back in if there is a major incident, such as a big road accident, and that could even include a worsening of waiting times at A&E – although the latter point has been disputed by the BMA
There are more than 55,000 junior doctors in England – a position covering people who have just graduated from medical school through to those with more than a decade of experience.
They represent a third of the medical workforce, and just over 37,000 are BMA members. Hospital consultants, GPs and other staff, including nurses and midwives are in work.