Summary

  1. Fourth strike involving junior doctors in England began at 08:00 BST on Wednesday and lasts 48 hours
  2. Doctors are providing emergency cover, but 5,000 operations and procedures are postponed
  3. Comes amid long-running dispute with government over planned changes to pay and conditions
  4. All-out stoppages planned for 08:00 to 17:00 BST on both 26 and 27 April

Live Reporting

By Lauren Turner, James Gallagher and Dominic Howell

All times stated are UK

Strike over, for now

Junior doctors have returned to work this morning after their fourth walkout in a dispute over the new junior doctors' contract.

A deal between the government and the British Medical Association is no closer after the 48-hour action and government sources say the doctors' union has blown its chance to negotiate.

The next strike is on the 26 and 27 April, from 08:00 to 17:00, when junior doctors will walkout of A&E and intensive care. This has never happened before in the history of the NHS.  

Junior doctors name baby as 'supporter of the day'

Could the ripple effect of the junior doctors row be toxic?

There is a chance ministers could end up undermining their long-term strategy, says health correspondent Nick Triggle. 

As well as potential issues with morale and attitude, there is a risk this dispute could have a real impact on the numbers staying in the NHS in England, he writes. 

Read more.

Doctors 'standing up for what they believe in'

Junior doctors have been posting pictures on Instagram of the industrial action today.

Instagram user offdutydoctor warned the NHS "is disappearing": 

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Sandy Robertson said he was demonstrating against "the imposition of an unsafe, unfair, discriminatory #juniorcontract": 

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Maevis Tan said she and her colleagues were "standing up for what we believe in": 

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Patient speaks of 'anxiety-ridden week' due to strike

One Twitter user has said they now have to wait until next week to receive vital results.

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In pictures: Strike action across England

Chairman of the BMA's junior doctors committee

The scene outside Charing Cross Hospital

Artists' impression of the picket line

We have seen plenty of photographs from the picket lines across England today - and now an artist has tweeted a picture she's drawn of the scene outside St Thomas' Hospital in central London. 

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Comedian and actress join picket line

Comedian Shappi Khorsandi and Margaret Cabourn-Smith, who has starred in Miranda and Peep Show, were among those to attend a rally at Ealing Hospital in west London this lunchtime.

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Drink doctor?

Alexander Gates, junior doctor

Strike figures

NHS trusts have reported today that 42.5% of junior doctors - out of a possible 26,000 working on a typical day - have turned up for duty on the day shift.

On Wednesday NHS England said 46% of junior doctors turned up for work at hospital.

The figures are broadly similar to previous walkouts earlier in the year - which stand at 39% and 44%.

Many doctors working will have been staffing emergency care services as agreed under the terms of the strike - there are about 17,000 junior doctors who are not British Medical Association members.

'What choice do we have left but to strike?'

Junior doctor Jonathan Barnes says he is “tired and worn down from the government's constant barrage of attacks on me and my profession" and that the new contract "will see doctors working more while earning less under less regulated and less safe conditions". 

Department of Health advice to patients

As a reminder, the DoH has issued the following advice to patients in England:

  • If you have a planned operation, procedure or outpatient appointment on these days your hospital will contact you if it needs to be rearranged
  • GP practices will be open and working as normal
  • If your condition is serious or life-threatening call 999 or go to A&E
  • If you need medical help but it’s not serious or life-threatening please contact your GP, visit your local pharmacist, call 111 or consult www.nhs.uk

'Doctors have prospects most could only dream of'

NHS Choir joins junior doctors' rally

The NHS choir has been performing - in the rain - outside Hackney Town Hall as part of a rally in support of the strike this afternoon. 

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British Medical Association: 'We have been left with no choice'

The British Medical Association (BMA) says that thousands of junior doctors have joined more than 140 picket lines across England. 

It notes that during the industrial action, they have organised blood drives and courses to teach life-saving skills to members of the public. 

Dr Johann Malawana, BMA junior doctor committee chair, said: 

No junior doctor wants to take this action but we have been left with no choice. The government is trying to impose a contract that is unfair and could undermine the long term delivery of patient care. The fact that junior doctors have again turned out in their thousands demonstrates the ongoing anger and rejection of this contract imposition.

He said that junior doctors "deeply regret any disruption caused to patients", and added:

Any future action is wholly avoidable, but the government must get back around the negotiating table and end this dispute through talks.

'Junior doctors have my full support - I know how hard they work'

The junior doctors considering a move overseas

Dr Jason Seebaluk
Jason Seebaluk

Fears have been raised that junior doctors could leave their jobs in the UK for jobs overseas if the new contracts come into force. 

The BBC has been speaking to some of those who are considering their future.  

Dr Jason Seebaluk, 27, who works in Euston, London, is moving to Australia later this year.

I have always wanted to gain some experience working overseas, but because of the proposed changes to junior doctor contracts I am quite certain my fiancee and I will now settle in Australia for good.

I am passionate about medicine and I realise this is the country where I was raised, but currently the rotas we are on just do not allow for any kind of work-life balance.

Junior doctor: 'We are not superhuman'

Junior doctors giving CPR lessons while on strike

Junior doctors on strike have been teaching CPR outside Stratford Station in London this morning. 

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While others have been getting creative with pavement art, as this tweet shows. 

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'Thank you for all you have done and all you will do for me'

A woman who was not well enough to stand with the junior doctors wrote this letter for them - as well as providing biscuits and a donation. 

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'Junior doctors are standing up for themselves'

Isabel Barnard, who has a rare liver disease, had an appointment for a liver biopsy cancelled yesterday. 

She said "the whole thing is up in the air" and that she has "no idea what's going on". 

Outpatient clinic delayed due to strike

A patient at an outpatients' clinic at a west London hospital sent this picture of a sign in the waiting room. 

A sign reading: "Due to Junior Dr's strike, the clinic is delayed, Our apologies, thank you'
BBC

Watch: Famous faces on the picket line

Green Wing cast join junior doctors picket line

There were some famous faces on one picket line yesterday, as actors from medical comedy Green Wing stood alongside junior doctors.

'Junior doctors need to get real'

While there has been support for the junior doctors on social media, others do not agree with the strike.

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Striking doctors 'are losing general public's support'

Gill Shaw contacted us to say that her mother's urgent heart operation had been cancelled yesterday. 

Her mother had initially gone to hospital last Thursday and been told she needed an operation. 

Get involved

We'd like to hear your views on the second day of the junior doctors' strike. 

To get in touch, email haveyoursay@bbc.co.uk.  

'Knock-on effect' of strike

Nick Triggle

Health Correspondent

NHS England has warned the second day of the strike is likely to prove more difficult. 

The concern is that without junior doctors there, hospitals may experience problems discharging patients - they play a vital role in chasing and checking test results and making the preparations for release from hospital. 

Delays discharging patients have a knock-on effect, meaning there are not the beds available for new patients coming in. 

And the whole hospital system then slows down.

What is the row all about?

A doctors' coat
Science Photo Library

Junior doctors' leaders are objecting to the prospect of a new contract in England. 

The government has described the current contract arrangements as "outdated" and "unfair", pointing out they were introduced in the 1990s - but unions say it is the new contract that is unfair and it will "exacerbate the staffing crisis".  

There are 55,000 junior doctors in England - a third of the medical workforce. 

The term junior doctor itself is somewhat misleading however, as it covers medics who have just graduated from medical school through to those who have more than a decade of experience on the NHS front line.

We have an in-depth piece on what the row is all about.   

No comment from Jeremy Hunt

Jeremy Hunt
BBC

There were no interviews from Health Secretary Jeremy Hunt yesterday - and he hasn't commented this morning either as he left his home on his bike.

Asked how many more strikes he thought there would be, Mr Hunt replied: "Sorry not giving any comments."

NHS England advice to patients

NHS England has reminded patients of information that may be useful as the second day of the strike gets under way.

The body said in a statement that it will "continue to make sure everything possible is being done to ensure safe emergency care is being provided and to minimise the impact of the action".  

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We also have a full guide on what patients need to know. 

Recap: What has happened so far

  • Junior doctors in England started the 48-hour walkout at 08:00 BST on Wednesday
  • More than 5,000 operations and procedures have been postponed as a result  
  • It is the fourth strike in their long-running dispute over a new contract
  • NHS England said 46% of junior doctors turned up to work on Wednesday
  • NHS England said it had made plans to deal with a "difficult" second day of the strike
  • Emergencies are being dealt with - but daytime strikes with no emergency care are planned on 26 and 27 April

NHS braced for 'difficult' strike day

NHS England says plans have been made to deal with a "difficult" second day of the strike.

Junior doctor on strike
PA

'Young doctors treated badly'

Email: haveyoursay@bbc.co.uk

'Support for strikes waning'

Telegraph front page
Telegraph

Among coverage in Thursday's papers, the Telegraph reports that support for the series of strikes appears to be waning.

"Almost half of medics decided to work yesterday instead of standing on the picket line," says the Telegraph. "The latest figures show a downward trend in the number of doctors prepared to strike, while it has emerged that the number of those withholding their labour has fallen at every walkout since January. NHS figures showed that 46% turned up for work yesterday."

'I will stay in the profession and keep fighting'

Email: haveyoursay@bbc.co.uk

Get Involved

Email: haveyoursay@bbc.co.uk

Green Wing stars - 'Hunt has completely botched this'

Green Wing cast join junior doctors picket line

Stars of Channel 4 sitcom Green Wing, Tamsin Greig, Stephen Mangan and Julian Rhind-Tutt, joined doctors on the picket line at Northwick Park Hospital in north-west London, where the medical comedy series was filmed. 

Mangan said he had watched the negotiations be "completely botched" by Jeremy Hunt.

He said he realised during filming that "the NHS is run on goodwill", adding: "In order to provide a fair NHS and ask people to work longer hours, you have to treat them fairly, it's not rocket science." 

The trio were joined by Pippa Haywood and Oliver Chris, who also appeared in the award-winning series.