For more than three years, England's National Health Service (NHS) operated under the near-constant threat of strikes by its resident doctors, the physicians in training who make up nearly half of the country's medical workforce. That chapter appears to be over. On June 29, 2026, resident doctors voted to accept a government offer, ending a dispute that produced 15 rounds of strikes since 2023 [1][2].
Who resident doctors are
Resident doctors, formerly called junior doctors, are qualified physicians who have not yet become consultants, the most senior hospital doctors. They range from recent medical school graduates to experienced doctors more than a decade into specialist training. Their union, the British Medical Association (BMA), represents about 55,000 of them [3].
Why they went on strike
The BMA argued that resident doctors' pay had fallen sharply in real terms since 2008 because raises did not keep pace with inflation [4]. Over time, the dispute widened from pay to jobs. Doctors reported a "bottleneck" in which many medical graduates could not obtain the specialty training posts needed to advance their careers, leaving some unemployed or stuck in temporary roles [2][5]. Strikes began in March 2023 under the Conservative government of Rishi Sunak. A deal with the new Labour government in 2024 briefly paused the action, but strikes resumed in 2025 [5]. In early 2026, members voted to extend their strike mandate for another six months, with 93% of those voting in favor [3].
A tense spring
The dispute hit a low point in April 2026. After the BMA rejected an offer that included a 3.5% pay rise and additional training posts, Prime Minister Keir Starmer gave the union 48 hours to call off a planned strike or lose 1,000 extra training places, calling a rejection "reckless" [4]. The BMA went ahead with a six-day walkout from April 7 to April 13, the 15th round of strikes since 2023 [6]. Health Secretary Wes Streeting had previously called the strikes "self-indulgent, irresponsible and dangerous" [3]. By late May, the government's leadership had changed. James Murray had replaced Streeting as Health and Social Care Secretary, and the BMA announced a four-day strike for June 15 to 19. "We had hoped that a change in leadership at the Department of Health and Social Care would lead to a change in approach," said Dr. Jack Fletcher, chair of the BMA's resident doctors committee [7]. Murray responded that after large raises in recent years, the BMA's demands for further substantial increases were "unrealistic, unaffordable, and unsustainable" [8].
The breakthrough
On June 13, two days before the walkout, the BMA called off the strike after receiving a new offer and put it to a vote of members [9][10]. NHS England said the deal could not improve the pay offer for the current financial year but recognized some costs unique to resident doctors in future years and created "significantly enhanced career progression opportunities" [10]. Members accepted the deal by 53% on a turnout of 57% [2]. According to the government and news reports, it includes [1][2]: • An average pay rise of 6.6%, fully implemented by April 2027, and a new pay structure with more frequent raises as doctors progress.
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Up to 4,500 additional specialty training places.
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Reimbursement of mandatory Royal College portfolio fees and exam costs, which can cost doctors thousands of pounds.
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Improved terms for locally employed doctors and those working less than full time. The government says resident doctor pay will now be 35.2% higher on average than four years earlier [1].
Both sides claim credit
"This is very good news for resident doctors, patients and the NHS as a whole," Murray said, adding that it allowed the health service to "draw a line under the disruption of previous months" [1]. Fletcher said doctors had "decided that the current offer is sufficient" and that "strikes will now end," but blamed the government for not offering the deal sooner [2]. The strikes came at a high price. The government estimates that each day of resident doctor strikes costs the NHS about £50 million, and there were 21 days of strikes between July 2025 and the deal alone [1]. Hospital leaders had warned that repeated walkouts threatened progress on waiting lists, although the government says waiting lists are now more than 400,000 lower than in June 2024 [1].
The jobs problem
The training places may prove to be the most important part of the deal. In recent years, the number of doctors applying for specialty training in England has far exceeded the number of available posts, and competition ratios became a central complaint in the dispute. The government says competition rates for training places have already halved this year, after it passed urgent legislation to prioritize graduates of UK medical schools and doctors who have spent a significant period working in the NHS [1]. That policy has been controversial with international medical graduates, who make up a large share of the NHS workforce, but the government argues it was necessary to ensure that doctors trained at public expense can complete their training at home.
Not entirely over
The agreement covers only resident doctors in England. Doctors in Northern Ireland, where health policy is handled by the devolved government, staged their own walkout in June over a similar offer [2][9]. The BMA also held a ballot of senior doctors in England, including consultants, from May to July, and the government says it is in discussions about consultant contract reform and pay structures for nurses and other staff [1][6].
Why it matters
The NHS is one of the world's most studied examples of a single-payer, government-run health system, and the dispute illustrates a challenge that many countries share: training and retaining enough doctors while keeping health spending under control. The resolution suggests that, at least in this case, jobs and career progression mattered nearly as much as pay. For American readers, the episode is also a reminder that in a publicly funded system, decisions about doctors' wages are made in public, through budgets, negotiations and, sometimes, picket lines.
Sources
- 1. UK Department of Health and Social Care, "Resident doctors agree deal with government to end strikes," June 29, 2026. https://www.gov.uk/government/news/resident-doctors-agree-deal-with-government-to-end-strikes
- 2. "Strikes to end as resident doctors accept pay deal," Sky News via Vibe 107.6, June 2026. https://www.vibe1076.co.uk/news/national-news/strikes-to-end-as-resident-doctors-accept-pay-deal/
- 3. "Resident doctors vote to continue industrial action for another six months over pay row," LBC, 2026. https://www.lbc.co.uk/politics/uk-politics/doctors-strike-nhs-vote-latest/
- 4. "Starmer gives resident doctors 48 hours to cancel strike or lose new package," Healthcare Management UK, April 2026. https://www.healthcare-management.uk/starmer-resident-doctors-48-hours-cancel-strike-lose-package
- 5. "How did we get to another NHS doctors' strike?" Sky News via Radio Royal, March 2026. https://www.radioroyal.org/news/politics/how-did-we-get-to-another-nhs-doctors-strike
- 6. "Tensions rising ahead of resident doctors' six-day strike," Sky News via Radio X, April 6, 2026. https://www.radiox.co.uk/news/uk-world/tensions-rising-ahead-of-resident-doctors-six/
- 7. "Resident doctors in England to strike in June," Shropshire Star, May 2026. https://www.shropshirestar.com/uk-news/resident-doctors-in-england-to-strike-in-june-8643296
- 8. "Resident doctors announce four-day strike in June," Sky News via Radio X, May 2026. https://www.radiox.co.uk/news/uk-world/resident-doctors-announce-four-day-strike-in/
- 9. "Doctors strike in England called off after new offer from government," Sky News via Vibe 107.6, June 2026. https://www.vibe1076.co.uk/news/national-news/doctors-strike-in-england-called-off-after-new-offer-from-g overnment/
- 10. NHS England, "Update on planned BMA resident doctor industrial action," June 13, 2026. https://www.england.nhs.uk/long-read/update-on-planned-bma-resident-doctor-industrial-action-13-june-2026/ Information in this article is current as of October 9, 2026. Bracketed numbers refer to the sources listed above.