The ballot, which saw 90% of resident doctors voting yes on a turnout of 55%, has provided a mandate for industrial action for six months up to January 2026.

The BMA's resident doctors committee co-chairs, Dr Melissa Ryan and Dr Ross Nieuwoudt, said: ‘Doctors have spoken and spoken clearly: they won't accept that they are worth a fifth less than they were in 2008. Our pay may have declined but our will to fight remains strong.

‘We now find ourselves at a crucial crossroads. Last year, when in opposition, Mr Streeting said that the solution to strikes was to talk to resident doctors. It was as true then as it is now. He made a point of acting quickly to grasp the issue and negotiate a solution. Only a few weeks ago he again said he wanted to get back round the table with us.

‘Now we will see if he can once again make the right decision. He needs to come forward as soon as possible with a credible path to pay restoration. All we need is a credible pay offer and nobody need strike.'

In response, Matthew Taylor, chief executive of the NHS Confederation, said: ‘Industrial action is hugely disruptive for the NHS, which is working incredibly hard to improve performance, reduce waiting lists and implement the reforms needed to put it on a sustainable long-term footing.

‘The recently published 10-Year Health Plan is an ambitious roadmap of how the NHS is going to balance the need for short-term improvement against long-term reforms. Resident doctors downing tools risks jeopardising both of these goals as it could see tens of thousands of appointments and operations cancelled as other staff – including consultants – are diverted over to cover staffing gaps. While there have been recent improvements in waiting lists, hitting the 92% target is a difficult enough ambition without further industrial action.

‘It is also disappointing that despite making ending the resident doctors' strikes a priority after entering office the government is now back to where it was a year ago. There is also the risk that these strikes heighten tensions within different staffing groups, with nurses and other staff also discussing industrial action.

‘A key part of making sure the 10-Year Plan is successful will be resetting the relationship between the NHS and the public. Turning around the perception that the health service is not there when people need it will be vital in the face of continued drops in public satisfaction. But further operations and procedures being cancelled due to industrial action is unlikely to reset the dial on this and could lead to further falls in public satisfaction with the NHS.'