Junior doctors guide to industrial action in England

On the day of strike action (full walkout)

Updated: Thursday 13 June 2024

Full walkout guidance

Below we look at what you should do on the days of strike action depending on whether you are scheduled to work or not or if you are already at work when the strike begins. 

Do not return to any shift that started within the strike period

You should not return mid-shift to any shift that started within the strike period even if the employer offers to pay you for time worked. You also run the risk of not getting paid for any part shifts. 

If you're already at work

You should finish your shift. As per the GMC's Good Medical Practice, you are responsible for ensuring an effective handover. This is essential as part of a patient's continuity of care.

If you're on call

The hospital may ask those who are on call in the evening to come in during the day. If you are asked and you are a junior doctor you can refuse. See our non-residential on-call advice.

If you're not scheduled to work

If you are not scheduled to work on a particular day of action, you personally would not need to take industrial action. You cannot have your wages deducted on this day either.

You are fully entitled to join in organised activities on the day, and we would encourage you to do so.

If you're scheduled to have a zero hour day

Doctors who are scheduled to have a zero hour day during, before, or after industrial action should continue to retain this, and will not be liable to lose pay whilst other doctors are undertaking industrial action, nor should they have their rota changed to remove their zero hour day.

The trust should not be proactively changing the rota schedule in ‘anticipation’ of strike action.

The zero hour days are contractual and are an important part of the work schedule so cannot be removed from a person’s rota.

If you’re scheduled for a SPA/SDT day 

Undertaking work on your portfolio, e-learning, audits or other self directed work is generally not undermining strike action if you are not clinically facing and so we would encourage you to continue with this, as we would for example for a conference booked with study leave. You should therefore also not have any pay deducted for continuing with this. We do not believe there should be any requirement for SPA/SDT work to be done on site and will support you to challenge any local policy which may say otherwise. However, just like any normal work day, if you were undertaking this work on a strike day, you could be redeployed to support a clinical area. In that instance, we would encourage you to strike instead. Your SPA/SDT day should be rescheduled for you and if not, and you are not given any other time to undertake this work, you should exception report for then having to do that work in your own time.

If you're scheduled to work a locum shift

Working locum shifts as a junior doctor during the strike (unless under an unavoidable contractual obligation - see our advice on this) will undermine the collective industrial action of junior doctors. This would likely prolong the strikes. 

If you're working somewhere else

You can potentially take leave to join the picket and other activities. This is as long as your contract does not prohibit this. See our guidance on taking part for more information.

GP registrars

GP registrars undertaking industrial action are only able to join picket lines at their usual place of work. For GP registrars working in a practice setting, this would mean picketing outside their practice.

We would encourage GP registrars who are taking part in IA, to join picket lines at their nearby hospital as we expect the majority of junior doctors on the selected days to demonstrate there.

See our guidance on how industrial action by junior doctors in the NHS will affect GP practices, trainers, and Local Medical Committees.

Calculating pay deductions

See our guidance.

NROC (Non-residential on-call rotas)

Regardless of strike action, it is an employer's responsibility to maintain any arrangements for ensuring that a junior doctor rostered to be on duty for a non-resident on call (NROC) period does actually report for that duty. For example, asking them to log into a system or give phone or email confirmation at the start of the duty period. We would expect employers to follow this procedure, at which point it would become apparent from the doctor not reporting in that they were participating in the strike action.

Alternatively, should a trust choose not to operate such a procedure or not follow their procedure, we would advise junior doctors can either decline to answer calls they receive as part of their NROC duty whilst they are on strike. Alternatively, if you do answer, simply explain to the trust "I am now on lawful strike action in line with BMA instruction".

In neither case is a junior doctor required to inform their employer of their intention to strike in advance of the duty period commencing.

Where you are rostered on the final day of action for a day shift then non-resident period combined together 

The contractual rules require that non-resident on-call duties and ordinary resident shifts must be rostered separately. However, we are aware that, for convenience, employers often show them combined on a rota, for example labelled just as an ‘on-call’ duty composed of a resident shift followed by a non-resident period overnight. Regardless of how this is reflected on the rota, our instruction to junior doctors is to strike from the daytime shift component but to perform the non-resident on-call duty component as normal.  

Dealing with pressure to return to work

We​ will support any junior doctor BMA member who is pressured to return to work outside of the escalation procedure. If you believe you are being pressured to go back to work, you should contact us as soon as possible.

It is important that you keep a note of what happened, including retaining emails.

If your employer takes action against you

The right to take industrial action is protected by UK employment law.

In cases where an employer takes action against a BMA member as a result of his or her involvement in industrial action, the BMA would provide support under the terms of the 'My BMA' contract of membership. Please refer to this for more details.

Other considerations

If you have an exam on a day of industrial action

You are able to do the exam on the day of action and take part in the industrial action activities around that. It is possible for your employer to cancel your leave, with any required notice under your contract. If your leave is cancelled, you will still be able to take industrial action and use the time to attend the exam.

You will likely lose a day of pay but you will still be able to take the day for industrial action and take your exam.

If you are unwell on a day of industrial action

Workers who are absent on sick leave when industrial action takes place keep their right to usual sick pay arrangements.

Employers can be expected to make their own judgement as to how to regard your absence if you call in sick on a day of action. 

Some employers have tried to introduce special rules about sick certificates in the event of sick leave during industrial action. If this is the case at your workplace, your LNC (local negotiating committee) should inform their BMA IRO (Industrial Relations Officer). They will take the matter up with management.

It is likely that some employers will say that they can insist on a medical certificate from an individual's doctor to cover absence on or around the period of industrial action. This is because they believe that these are exceptional circumstances. Some contracts do include a clause specifying this. If there is not an expressed provision in contracts then your employer may refer to their own absence/sickness reporting procedures. It is our understanding that these procedures may also have an exceptional circumstances clause.

Time Out of Training (TOOT) quotas
In the event of a 'major casualty event'

A major casualty event could take a number of forms. For example, a major accident or security incident.

The pressure which hospitals find themselves under on a regular, sometimes daily basis does not constitute such an event. Your trust calling a critical incident will not in itself meet our criteria. In the event of a “major casualty event” the trust should urgently contact NHS England. If NHS England agree that the situation may justify asking junior doctors to return to work, such request will be submitted to the BMA for urgent consideration.

Derogations: returning to work in exceptional circumstances

A derogation is an exemption from industrial action. As we have given trusts enough time to plan and make appropriate cover arrangements, we do not expect to have to grant many, if any, derogations in the 72-hour period. Local agreements to run services should have been reached between employers and other members of staff, and elective and non-urgent care cancelled where necessary. However, in the event of an externally declared major or mass casualty incident that affects the normal resources of the emergency and healthcare services’ ability to manage, we have a clear process agreed with NHS England set out. Derogations will first need to be agreed by the BMA at a national level. If there is a derogation at your department or Trust, you’ll be asked to return to work by your Trust and we will confirm this on our Twitter account and strike action toolkit as soon as possible. Please always check for a verification from the BMA.

Junior doctors on strike should not be asked to return to work unless we confirm a derogation. We have agreed with NHS England (NHSE) a failsafe bypass mechanism whereby the Trust may ask you to return to work in parallel with central escalation to NHSE and the BMA to allow you to use your discretion if you hear of a massive event occurring that you feel you need to help with. This should be exceptional, will be audited, and will be subject to review of our arrangements in future industrial action.


Still have questions?

If you can't find the information you need in this guide, send us your questions here and we will add the answers to these pages.


Or contact our member relations team at [email protected] if you have a question about your personal circumstances.