Junior doctors in England are set to begin a five-day strike – the 11th walkout in their long-running pay dispute.

British Medical Association (BMA) members will walk out from 07:00, with NHS England warning of significant disruption to routine hospital services.

The union said it was taking action as there had been no credible new offer – the last walkout was in February.

But NHS bosses have criticised the timing of the latest action – in the week running up to a general election.

The NHS Confederation said striking during the election campaign, when none of the political parties was in a position to resolve the dispute, was a “bitter pill to swallow”.

The two sides had agreed to independent arbitration, in May – but that was put on hold when the election was called. And the union then called the strike.

It has asked for a 35% rise, to make up for what it says are 15 years of below-inflation pay rises.

Junior doctors received a pay rise averaging nearly 9% in the last financial year.

The BMA last year walked out of talks in which an extra 3% pay rise on top was discussed.

Junior doctors make up nearly half the medical workforce in the NHS and two-thirds of them are BMA members, so NHS England is warning of significant disruption, pointing out the health service is already under extra pressure this week due to the hot weather.

Yellow heat alerts announced for many parts of the country indicate the weather could pose a risk to those particularly vulnerable.

It can cause heat-stroke and exhaustion as well as worsening respiratory and heart problems.

The latest strike will see junior doctors walk out of all services, with senior doctors drafted in to provide cover.

It is expected to cause most disruption to elective services in hospital, such as routine operations.

NHS England has urged the public to use the health service responsibly – but people should still use 999 for emergencies and NHS 111 for urgent needs.

Those with routine appointments and treatments should attend unless told otherwise, NHS England said.

GP services and pharmacies will also be available.

Medical director Stephen Powis said he expected this latest strike to “hit the NHS very hard”.

And Matthew Taylor, chief executive of the NHS Confederation, which represents health leaders, criticised its timing.

“While we fully understand the genuine grievances junior doctors have over their pay, conditions and training, NHS leaders will still be frustrated that they will yet again be taking to the picket lines,” he said.

“Holding strikes in the middle of an election campaign, when no political party is in a position to bring the dispute to a close, is a bitter pill to swallow for staff who have to plug the gaps and patients who will have their appointments cancelled or delayed.”

Nearly 1.5 million appointments and operations have been cancelled because of strike action in the NHS in England, at an estimated cost of £3bn.

Anita Wheeler, 75, a former nurse from Reading, is one of those that has had care postponed because of the dispute. She has a condition called plantar fasciitis which causes her pain in her ankle and foot.

Her trauma and orthopaedics outpatient appointment for her foot was cancelled because of the junior doctor’s strike in March 2023. She says she sympathises with people in the same position this time around.

“I’ve been in this position before, so I know what it’s like, you build yourself up and think you’re going to get treated and then they turn around and say it’s cancelled.”

“These delays impact people lives.”

“When I found out my appointment was cancelled, I broke down and cried.

The BMA said the blame lay at the government’s door, criticising it for “not once making a credible offer” during the dispute. And it was now willing to have the 35% pay rise phased in, after initially calling for it in one go.

But ministers have always maintained the demands are unreasonable.

All the political parties, including the Conservatives, have said they would want to resolve the dispute if they formed the next government and would be willing to sit down for talks.

But only the Green Party has committed to meeting the demands for a 35% pay increase.

In England, consultants, nurses and midwives, alongside non-medical staff, have all accepted pay offers over the past 14 months .

And elsewhere in the UK, planned strike action has been suspended, with doctors in Wales voting on a new offer, and fresh talks in Northern Ireland.

Junior doctors in Scotland have not taken industrial action, after a pay deal was agreed last summer.