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A 48-hour strike by senior hospital doctors in England will get under way early on Thursday, with NHS bosses warning of severe disruption.
Thousands of consultants will walkout from 07:00 BST in a dispute over pay.
It will be the first time consultants have taken part in strike action since 2012.
Only emergency care and a small amount of routine work- so-called Christmas Day cover – will be provided.
It comes just two days after a five-day walkout by junior doctors came to an end, on Tuesday.
NHS England said that the timing of the industrial action had left hospitals with little time to recover, claiming the senior-doctor walkout would have the most severe impact of any strike action so far this year.
Thousands of planned appointments have been postponed.
Consultants will stop seeing many patients and will not be around to supervise the work of junior doctors.
British Medical Association consultants’ committee chair, Dr Vishal Sharma, said members were “angry” and at “rock bottom” thanks to years of below-inflation pay rises.
“We are under-valued and over-worked. This government is failing us and failing patients.”
But Health Secretary Steve Barclay urged the profession to end the dispute.
He said the government had listened to their concerns, by increasing the amount that can be paid directly into pension pots tax-free, as well as accepting the recommendations of the independent pay review body and giving consultants a 6% pay rise this year.
He stressed it was the government’s “final offer”, adding: “It is now time to put patients first.”
What do patients need to know?
On the strike days, people should use 999 in life-threatening emergencies, and NHS 111 online for other health concerns.
GP services and pharmacies can also be accessed in the normal way.
Those not told their appointments have been postponed should attend as normal.
How much do consultants get paid?
The 6% pay increase means basic pay starts at £93,666 – with the most experienced consultants receiving more than £126,000 a year – but to reach that salary takes, on average, 19 years in the role.
However, the average NHS consultant earns approximately 30% more than their stated salary – about half of this is for working additional hours, with the rest made up of other allowances – including a bonus system known as clinical excellence awards.
They can also be paid additionally for private work – but not all do it.
Has pay fallen over time?
Yes, but depending on what measure is used the scale of the cut in pay varies.
The BMA uses the RPI measure of inflation, which shows, since 2008, pay has fallen by 27%.
Once changes to tax and pensions over this period are factored in, the shortfall in take-home pay is 35%, the BMA says.
But work by the Institute for Fiscal Studies, using other measures of inflation, shows the fall since 2010 is around 17%.
This drop in pay is greater than most other NHS workers, such as nurses, ambulance staff and estates staff, with lower-paid staff prioritised for the biggest pay rises.
The BMA said it means consultants have seen their pay eroded when compared to professions such as law, accountancy, financial services and engineering.
Unlike the junior-doctors’ dispute, consultants are not asking for full pay restoration in one uplift.
Instead, they want the government to start giving pay rises that at least match inflation.
Consultants plan more industrial action, on 24 and 25 August, unless a pay deal is agreed.
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