Junior doctors strike: Appointments and operations cancelled as 24-hour walk out starts

Disruption was caused at hospitals across the Black Country and Staffordshire - forcing bosses to work on contingency plans to help ease the pressure.

The walk out happened despite an 11th hour plea from Prime Minister David Cameron claiming the 'damaging' strike causes 'real difficulties' for patients and 'potentially worse'.

Hospital trust officials said waiting times for people needing treatments were likely to be hit, piling on the delays and disruption.

Last night, most hospital trusts were unable to give a clear picture on how many appointments were cancelled due to the walkout.

But officials in charge of Sandwell Hospital said five surgical procedures and 126 outpatient appointments had been cancelled.

Sandwell and West Birmingham Hospital NHS Trust, which also managed City Hospital in Birmingham and Rowley Regis Hospital, said it had worked to minimise disruption.

The Government is intent on introducing a new contract for doctors working up to consultant level to replace one it says is "outdated".

Health Secretary Jeremy Hunt wants to introduce a "truly seven-day NHS". He plans to cut the number of hours on a weekend that junior doctors can claim extra pay.

Under the most recent proposals, doctors will receive an 11% rise in basic pay but extra pay for "unsocial" hours will be cut.

Currently, 7pm to 7am Monday to Friday and the whole of Saturday and Sunday attract a premium rate of pay.

Under the new plans, a higher rate would run from 10pm to 7am Monday to Friday, and from 7pm on Saturday evenings (a concession on the previous 10pm).

Mr Hunt argues that, under the new deal, just 1% of doctors would lose pay and those would be limited to doctors working too many hours already.

He said maximum working hours per week would fall from 91 to 72.

Johann Malawana, the British Medical Association's junior doctor committee chairman, has said the increase in basic pay is misleading due to the changes to pay for unsocial hours.

He said it devalues the vital work junior doctors do in the evenings and at weekends.

The BMA also has a range of other concerns, including on protecting doctors working in some specialties.

Haven't doctors threatened to strike before?

Three strikes were called off at the 11th hour on November 30 after the Government, the BMA and NHS Employers agreed to continue talks through the Advisory, Conciliation and Arbitration Service (Acas). There were three weeks of talks up to Christmas and then one day of negotiations, which failed to reach an agreement.

When will the strikes happen?

Junior doctors will provide emergency care only from 8am today.

This will be followed by two further spells of strike action, with a 48-hour stoppage and the provision of emergency care only from 8am on Tuesday January 26.

Trust medical director, Dr Roger Stedman, said: "We have worked closely with our senior medical staff to ensure that there is appropriate cover for the clinical work that is to be undertaken.

Strike action was due to last until 8am tomorrow with two further walk outs planned at the end of January and beginning of February.

Officials running Walsall Manor Hospital said they had been in talks with the British Medical Association which was leading the strike action.

Walsall Healthcare NHS Trust medical director, Amir Khan, said: "The safety of patients will remain a priority and we are doing all we can to ensure minimal disruption, there may be some delays or cancellations however and this is unavoidable."

The trust confirmed some elective surgery procedures have been postponed during this period.

Dudley Group NHS Foundation Trust, which runs Russells Hall Hospital, said staff had been urging people to call the non-emergency NHS 111 service to get advice on alternative treatments to ease the pressure on stretched services.

Trust chief operating officer, Paul Bytheway, said: "It is very likely that some outpatient and other appointments will need to be rescheduled. All patients affected will be contacted directly and offered an alternative appointment in the future."

The Prime Minister urged medics to re-enter negotiations yesterday, adding: "This strike is not necessary, it will be damaging.

"We are doing everything we can to mitigate its effects but you can't have a strike on this scale in our NHS without there being some real difficulties for patients and potentially worse."

NHS England said 1,425 inpatient operations and procedures were being cancelled as a result of the strike along with 2,535 outpatient ones.

It said there are around 4,000 cancellations in total, of which 3,400 are on Tuesday.

Issues being disputed by the BMA and NHS include weekend pay and whether there are appropriate safeguards in place to stop hospitals over-working doctors.

The basis for the current round of negotiations is the Government's offer from early November, including an 11 per cent rise in basic pay for junior doctors.

This is offset by plans to cut the number of hours on a weekend for which junior doctors can claim extra pay for unsocial hours.

Currently, 7pm to 7am Monday to Friday and the whole of Saturday and Sunday attract a premium rate of pay.

Under the Government's offer, junior doctors would receive time-and-a-half for any hours worked Monday to Sunday between 10pm and 7am, and time-and-a-third for any hours worked between 7pm and 10pm on Saturdays and 7am and 10pm on Sundays.