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Britain’s junior doctors will join consultants in the first coordinated strike by medical staff in the NHS’ 75-year history, marking a sharp escalation in their dispute with the government over pay.

The first major strike will take place on September 20 in what Health Secretary Stephen Barclay described as “ruthless and calculated”, followed by the ruling Conservative Party’s annual conference on October 2-4. A three-day strike was held.

BMA (Doctors Union) explain Its members will only provide emergency “Christmas” services for four days, with further separate strike action planned by two groups of clinicians.

The union announced the coordinated action after junior doctors voted 98% in favor of continuing the strike action they started in March, with a turnout of 71%. Advisers announced a strike date for October last week.

The escalation will further dent Prime Minister Rishi Sunak’s hopes of calling the next general election, due next year, as the number of people waiting for the NHS falls from a record 7.6 million.

Julian Hartley, chief executive of NHS Providers, which represents health organizations across England, said a mass strike would be an “unprecedented challenge”. He noted that in addition to the joint action, consultants are planning to strike on September 19, while junior doctors are planning to strike on September 21-22.

He said nearly a million appointments had been postponed since the NHS strike wave hit in December, when nurses who had settled down were the first to strike.

Barclays described junior doctors’ renewed strike order as “extremely disappointing”. He said it would “put a heavy burden on NHS colleagues and patients – who are all bearing the brunt of the BMA’s relentless and now coordinated strike action”.

The government has accepted the independent pay review body’s recommendation that a 6% pay rise, with an extra £1,250 paid into the basic salary of junior doctors, has asked for a 35% rise.

Junior Doctors Committee co-chairs Dr Rob Laurenson and Dr Vivek Trivedi urged Sunak to intervene. “The prime minister has the power to stop any further action by making a credible offer to our members. Refusing to negotiate with us and our advisory colleagues is not the right way to go”.

Barclays said his door was “always open to discuss how we can work with NHS staff to improve their working lives”. But he declined to discuss the pay issue, insisting that the review body’s decision was final.

NHS Federation chief executive Matthew Taylor described the joint operation as “the nightmare scenario that NHS leaders have long feared”. He added that the move was “going too far and will cause unnecessary delay and distress to patients”.

Shadow health secretary Wes Streeting said: “The failure of the prime minister and his health minister to sit down with doctors has now resulted in the worst strike action to date.”

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