Summary

  • Fourth strike involving junior doctors in England began at 08:00 BST on Wednesday and lasts 48 hours

  • Doctors are providing emergency cover, but 5,000 operations and procedures are postponed

  • Comes amid long-running dispute with government over planned changes to pay and conditions

  • All-out stoppages planned for 08:00 to 17:00 BST on both 26 and 27 April

Live Reporting

Lauren Turner, James Gallagher and Dominic Howell

  1. What should patients do during the strike?

    What should patients do during the 48 hours of the walkout?

    Junior doctors will run an "emergency care-only" model. Effectively, this means some of them will still be on rota to work in A&E and cover other emergency services in hospitals. But they will not do any non-urgent work - this will either be cancelled or picked up by colleagues.

    Doctors say they want to minimise any disruption to patients, but some services will unavailable or reduced. Others will be largely unaffected.

    We have a full guide on what to do here.

  2. Junior doctors' row: Everything you need to know

    Graph

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

    The term junior doctor is a little misleading. 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.

    In total, there are 55,000 junior doctors in England - representing a third of the medical workforce.

    The government has described the current contract arrangements as "outdated" and "unfair", pointing out they were introduced in the 1990s - but unions say it is the new contract that is unfair and it will "exacerbate the staffing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

    Read our full piece explaining the junior doctors row.

  3. Recap: How did we get here?

    • Talks at conciliation service Acas broke down in January
    • A final take-it-or-leave it offer was made by the government in February but was rejected by the British Medical Association (BMA)
    • Ministers subsequently announced the contract would be imposed in the summer
    • It will reduce the amount paid for weekend work, but basic pay is being increased
    • The BMA wants a more generous weekend pay allowance and more investment for more seven-day services (the government is not increasing the overall budget for junior doctors' pay)
    • Two legal challenges are being pursued by doctors against the imposition
    • Hospitals are pushing ahead with the new contract - offers are expected to go out in May
    • The government is refusing to reopen talks, arguing it made compromises earlier in the year

  4. Fourth junior doctors' strike begins

    StrikePA

    Hello and welcome to our live coverage of the fourth strike by junior doctors in England in their long-running contract dispute with the government.

    The 48-hour strike started at 08:00 BST.

    Doctors are again providing emergency cover, but 5,000 operations and procedures have been postponed.

    Meanwhile doctors are also preparing legal challenges to the government's decision to impose changes to their pay and conditions from this summer.  

    NHS England said the continued disruption was "deeply regrettable".

    Read more here.