NHS braced for Christmas disruption as doctors' five-day strike could cancel up to 70,000 appointments

As many as 60,000 to 70,000 operations and appointments could be cancelled this week as resident doctors begin another five-day walkout, the NHS says. Health leaders warn that more patients are likely to feel the impact this time around, as the action coincides with a record winter flu outbreak and staff holidays.

The five-day strike runs from 7 a.m. today until 7 a.m. Monday. Hospitals have been told to aim for 95 percent of usual activity, though officials acknowledge winter pressures and the flu could push disruption higher. If the figure settles around 90 percent, about 60,000 to 70,000 appointments and operations could be affected.

Officials say the disruption will add to mounting pressures as flu admissions swell. Beds are increasingly full, some hospitals have declared critical incidents and ambulances are diverted to other A&Es, while many staff are off sick or on annual leave during the holidays. The timing raises concerns about patients waiting weeks, months or longer for procedures.

Meghana Pandit, national medical director at NHS England, said the strikes come at an immensely challenging time for the NHS, with record numbers of flu patients in hospital for this time of year. She added that while staff will come together to provide safe care and limit disruption, more patients are likely to feel the impact than in previous rounds, and those covering shifts will not get the Christmas break they deserve with their families.

Caroline Abrahams, charity director at Age UK, warned that older Britons will be hit hardest. "The postponement of a minor operation or a clinic appointment to discuss test results and next steps may look 'non-urgent' on paper, but that's not how it will feel to an older person who is anxious and in pain, who has already waited months and who does not have time on their side." She added that the disruption would compound existing vulnerabilities for older people.

NHS England has urged the public to come forward for their appointments unless contacted with a change, and to get flu vaccination where eligible to help ward off illnesses during the peak season.

This latest action is the 14th round of strikes by resident doctors since March 2023, totaling 59 days of disruption to NHS services. The last five-day walkout in November led to the cancellation of 38,961 appointments despite 95 percent of usual activity.

Mike Prentice, the NHS national director for emergency planning, urged leaders to focus on reducing hospital bed occupancy before, during and after the industrial action as the holiday period approaches. He said, "These strikes will be followed by two full working days before Christmas ... huge effort will be needed to safely discharge patients and get people home in time for Christmas."

Health secretary Wes Streeting criticized the walkout as abandoning patients in their hour of greatest need and warned the strike was taking place at a moment of 'maximum danger'. The government argued it had offered concessions while negotiations continued.

Members of the British Medical Association voted 83 percent to 17 percent to proceed with the industrial action, rejecting a fresh government offer that included more senior training places and help with exam fees. The government had proposed extending the mandate to January to avert the strike, but the union chose to proceed.

Dr Jack Fletcher, chair of the BMA's Resident Doctors Committee, warned the strikes could continue into the New Year if the government does not deliver a lasting deal. "If the Government keeps up the pattern of denial, harsh words and rushed half-measures, then we are going to be stuck in the cycle of strikes well into the New Year," he said.

Analysts say the strike wave underscores the NHS's fragile winter footing as flu cases rise and elective care waits lengthen. NHS England has urged the public to stay away from emergency departments unless necessary and to seek timely care as the situation evolves.