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Summary

  1. Fourth strike involving junior doctors in England began at 08:00 BST on Wednesday and lasts 48 hours
  2. Doctors are providing emergency cover, but 5,000 operations and procedures are postponed
  3. Comes amid long-running dispute with government over planned changes to pay and conditions
  4. All-out stoppages planned for 08:00 to 17:00 BST on both 26 and 27 April

Live Reporting

By Lauren Turner, James Gallagher and Dominic Howell

All times stated are UK

  1. Strike over, for now

    Junior doctors have returned to work this morning after their fourth walkout in a dispute over the new junior doctors' contract.

    A deal between the government and the British Medical Association is no closer after the 48-hour action and government sources say the doctors' union has blown its chance to negotiate.

    The next strike is on the 26 and 27 April, from 08:00 to 17:00, when junior doctors will walkout of A&E and intensive care. This has never happened before in the history of the NHS.  

  2. Could the ripple effect of the junior doctors row be toxic?

    There is a chance ministers could end up undermining their long-term strategy, says health correspondent Nick Triggle. 

    As well as potential issues with morale and attitude, there is a risk this dispute could have a real impact on the numbers staying in the NHS in England, he writes. 

    Read more.

  3. Doctors 'standing up for what they believe in'

    Junior doctors have been posting pictures on Instagram of the industrial action today.

    Instagram user offdutydoctor warned the NHS "is disappearing": 

    View more on instagram

    Sandy Robertson said he was demonstrating against "the imposition of an unsafe, unfair, discriminatory #juniorcontract": 

    View more on instagram

    Maevis Tan said she and her colleagues were "standing up for what we believe in": 

    View more on instagram
  4. Artists' impression of the picket line

    We have seen plenty of photographs from the picket lines across England today - and now an artist has tweeted a picture she's drawn of the scene outside St Thomas' Hospital in central London. 

    View more on twitter
  5. Comedian and actress join picket line

    Comedian Shappi Khorsandi and Margaret Cabourn-Smith, who has starred in Miranda and Peep Show, were among those to attend a rally at Ealing Hospital in west London this lunchtime.

    View more on twitter
  6. Strike figures

    NHS trusts have reported today that 42.5% of junior doctors - out of a possible 26,000 working on a typical day - have turned up for duty on the day shift.

    On Wednesday NHS England said 46% of junior doctors turned up for work at hospital.

    The figures are broadly similar to previous walkouts earlier in the year - which stand at 39% and 44%.

    Many doctors working will have been staffing emergency care services as agreed under the terms of the strike - there are about 17,000 junior doctors who are not British Medical Association members.

  7. 'What choice do we have left but to strike?'

    Junior doctor Jonathan Barnes says he is “tired and worn down from the government's constant barrage of attacks on me and my profession" and that the new contract "will see doctors working more while earning less under less regulated and less safe conditions". 

  8. Department of Health advice to patients

    As a reminder, the DoH has issued the following advice to patients in England:

    • If you have a planned operation, procedure or outpatient appointment on these days your hospital will contact you if it needs to be rearranged
    • GP practices will be open and working as normal
    • If your condition is serious or life-threatening call 999 or go to A&E
    • If you need medical help but it’s not serious or life-threatening please contact your GP, visit your local pharmacist, call 111 or consult www.nhs.uk
  9. 'Doctors have prospects most could only dream of'

  10. NHS Choir joins junior doctors' rally

    The NHS choir has been performing - in the rain - outside Hackney Town Hall as part of a rally in support of the strike this afternoon. 

    View more on twitter
  11. British Medical Association: 'We have been left with no choice'

    The British Medical Association (BMA) says that thousands of junior doctors have joined more than 140 picket lines across England. 

    It notes that during the industrial action, they have organised blood drives and courses to teach life-saving skills to members of the public. 

    Dr Johann Malawana, BMA junior doctor committee chair, said: 

    Quote Message: No junior doctor wants to take this action but we have been left with no choice. The government is trying to impose a contract that is unfair and could undermine the long term delivery of patient care. The fact that junior doctors have again turned out in their thousands demonstrates the ongoing anger and rejection of this contract imposition.

    He said that junior doctors "deeply regret any disruption caused to patients", and added:

    Quote Message: Any future action is wholly avoidable, but the government must get back around the negotiating table and end this dispute through talks.
  12. 'Junior doctors have my full support - I know how hard they work'

  13. The junior doctors considering a move overseas

    Dr Jason Seebaluk

    Fears have been raised that junior doctors could leave their jobs in the UK for jobs overseas if the new contracts come into force. 

    The BBC has been speaking to some of those who are considering their future.  

    Dr Jason Seebaluk, 27, who works in Euston, London, is moving to Australia later this year.

    Quote Message: I have always wanted to gain some experience working overseas, but because of the proposed changes to junior doctor contracts I am quite certain my fiancee and I will now settle in Australia for good.
    Quote Message: I am passionate about medicine and I realise this is the country where I was raised, but currently the rotas we are on just do not allow for any kind of work-life balance.
  14. Junior doctor: 'We are not superhuman'