The RDC met on Tuesday afternoon (22 July) and agreed that there was no choice other than to continue with planned action.

RDC co-chairs, Dr Melissa Ryan and Dr Ross Nieuwoudt, said: ‘Unfortunately, we did not receive an offer that would meet the scale of those challenges. While we were happy to discuss non-pay issues that affect doctors' finances we have always been upfront that this is at its core a pay dispute. The simplest and most direct means of restoring the more than a fifth of our pay that has eroded since 2008 is to raise our pay. While we were keen to discuss other items, it was made very clear by the Government that this obvious course of action was going to remain off the table.

‘Student debt and the cost of training remain crushing burdens on the finances of resident doctors. We had hoped that there would be enough new ideas about relieving these burdens that we could make some progress in these talks. Disappointingly, what we saw would not have been significant enough to change the day-to-day financial situation for our members. The non-pay aspects of last year's pay deal have still not been delivered, which has shaken the confidence of our members that any further non-pay elements would be honoured.'

They added: ‘What we have seen so far is a series of "nos" – no to movement on pay, no to student loan forgiveness, no to any credible move forwards. What we need to see are some ways forward, some kind of positive approach to get us out of this dispute. At present it looks as if these talks have not seen such a breakthrough and so regrettably, strikes must now proceed.

‘However, our door remains open, and we are glad to have met with the secretary of state in a constructive spirit. We want to keep talking – but we don't accept we can't talk about pay.'

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Professor Meghana Pandit, NHS England Co-National Medical Director (Secondary Care), said: ‘This new round of strikes by resident doctors will no doubt be incredibly challenging for the NHS, and while local services are working extremely hard to minimise the impact for patients, as they always do, some disruption to services is inevitable.

‘We urge the BMA to work with NHS England and local trust medical directors and leaders to minimise the impact their actions have on essential care.'

In response, Daniel Elkeles, chief executive of NHS Providers, said: 'This decision is a crushing blow for patients and for the NHS. Trusts have been holding off cancellations while there was the realistic prospect of a breakthrough. They will now be doing all they can to ensure there are fewer – and in some cases many fewer – cancellations than last time.

'Safety is paramount, so unfortunately there will be some disruption for patients because of the need to provide cover. We urge resident doctors to help trusts minimise the harm by notifying them of their plans for strike days. For example we must ensure that there are enough staff for all the cancer, transplant and maternity care that cannot and must not be delayed.

"Another huge worry is the cost. It is vital that consultants providing cover take NHS rates of pay rather than insisting on inflated BMA rates that are simply unaffordable.

'All avenues for discussion should be exhausted before turning to strikes. We say to the BMA ‘think again' and pull back from this hugely damaging decision.'