NHS England and the British Medical Association are now clashing over how much risk the health service can safely take during the looming five-day doctor strike. NHS England has told trusts to cancel only the least-urgent operations—mainly the routine hip and knee replacements—if absolutely necessary. The BMA argues this directive threatens patient safety, insisting that clinics and specialists outside the strike's reach will not be able to cope with the rising tide of urgent cases.
The BMA now speaks for 48,000 doctors, almost two-thirds of the country's total, and has already shown how quickly its members can withdraw routine care. During earlier stoppages in 2023 and 2024, many more non-urgent treatments came off the books to release senior staff for the most acute demands. The latest escalation follows NHS England's recent instruction that trusts must also amend clinic and ward hours, language it has branded "sadly necessary" for patient safety. Sir Jim Mackey, who stepped up as chief after Amanda Pritchard stood down in the spring, is now supervising the rollout of this directive.
NHS England's executives insist that he is determined to keep problems to a minimum, pointing out that cancelling non-urgent work also carries risks for those patients who will be left to wait longer. In a letter to chief executives last week, the department insisted that timetable shifts should occur only when the evidence is clear and only with the explicit agreement of the relevant board.
After talks with NHS England, the BMA union sent a letter to Sir Jim. They are worried about how things are being run.
The letter, from BMA's bosses Dr. Tom Dolphin and Dr. Emma Runswick, says: "It's key that hospital care changes to match staff on strike days. Telling hospitals to keep up non-urgent care makes staffing too thin." Prof Meghana Pandit, from NHS England, said: "The best way to keep patients safe is for the NHS to keep up urgent and planned care during strikes. We hope the BMA will help us do this if the strike happens." Talks between the government and BMA to stop the strike have been going on since Thursday.
Health Secretary Wes Streeting has said no to more pay this year. Still, they are looking at other things like student debts, exam fees, and work rules. The strike must be stopped by Wednesday morning to stop big problems.