Junior doctors in England have begun their 14th strike in the long-running pay dispute from Wednesday morning, walking out for five days in action that NHS leaders warn will cause significant disruption to non-urgent care as hospitals battle a severe flu wave.

The strike, which started at 07:00 GMT, sees resident doctors (formerly junior doctors) withdraw from both emergency and routine services, with senior consultants stepping in to cover. The British Medical Association (BMA) pressed ahead despite warnings of “immense challenges,” rejecting a government offer that included more speciality training posts and expense reimbursements.

Health Secretary Wes Streeting accused the BMA of deliberately scheduling the strike to “inflict maximum damage” during peak winter pressures, adding: “This year is harder with super flu.” NHS England medical director Prof Meghana Pandit said more patients will face cancellations than during the July and November strikes, with staff missing Christmas breaks.

NHS Providers CEO Daniel Elkeles described the action as the “worst possible Groundhog Day,” predicting thousands of postponed operations. Flu inpatients have hit record highs for December, compounding staffing strains.

The BMA insists the strikes are necessary after pay fell by around 20% in real terms since 2008, despite recent rises. Resident doctor leader Dr Jack Fletcher said: “Ministers need a long-term plan on pay and jobs—no more strikes if addressed responsibly.”

Emergency and urgent care remain available, with patients urged to use NHS 111 online first. Some hospitals, including Cheltenham General, closed their A&E departments for emergencies during the strike.

The dispute, ongoing since 2023, has already seen 13 prior walkouts. Last-minute talks on Tuesday were described as “constructive” but insufficient to avert the latest action. Patients are advised to attend appointments unless cancelled, and to use pharmacies or GPs for non-emergency needs.