Hospital consultants in England will down tools next month in a bitter dispute over pay.
The British Medical Association confirmed that top medics would go on strike on July 20 and 21 after 24,000 members backed industrial action by 86% on a turnout of 71% - well above the legal threshold of 50%.
Most routine and elective services will be cancelled but full emergency cover will remain in place, similar to Christmas Day cover.
The walkouts coincide with a bumper day of by-elections on July 20 - with contests in Boris Johnson's old seat of Uxbridge and South Ruislip, as well as Selby and Ainsty, and Somerton and Frome.
It comes as junior doctors prepare to stage a five-day walkout between 7am on July 13 and 7am on July 18 after ministers resisted demands for a 35% pay hike to restore wages to pre-austerity levels.
But nurses will end their strike action after a Royal College of Nursing (RCN) ballot to extend their strike mandate by six months failed to meet the legal turnout threshold.
Dr Vishal Sharma, BMA consultants committee chair, said: “We know consultants don’t take the decision around industrial action lightly, but this vote shows how furious they are at being repeatedly devalued by Government. Consultants are not worth a third less than we were 15 years ago and have had enough.
“Consultants don’t want to have to take industrial action, but have been left with no option in the face of a Government that continues to cut our pay year after year."
The Government could end the strikes if it came back with "a credible offer that we can put to our members", Dr Sharma said.
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Shadow Health Secretary Wes Streeting said: “This is an unmitigated disaster of the Government’s making and the risk to patients and the NHS is intolerable.
"Rishi Sunak cannot continue to sit back like a passive observer and let this go ahead. He must now get the doctors in for immediate negotiations to bring these strikes to an end.
"If Rishi Sunak has time to negotiate honours with Boris Johnson, he can negotiate with NHS doctors."
The BMA has been left isolated in its strike action after the RCN failed to secure a mandate for more walkouts.
In an email to members, RCN general secretary Pat Cullen said: “To every one of you who took part, whether by voting or encouraging others to, thank you. We have so much to be proud of.
“While the vast majority of members who returned their ballot papers voted in favour of strike action, we did not meet the 50% turnout threshold necessary for us to be able to take further strike action.
“While this will be disappointing for many of you, the fight for the fair pay and safe staffing that our profession, our patients, and our NHS deserves, is far from over."
A Department of Health and Social Care spokesperson said: “We hugely value the work of NHS consultants and it is disappointing the BMA consultants have voted to take strike action. Consultants received a 4.5% pay uplift last financial year, increasing average earnings to around £128,000, and they will benefit from generous changes to pension taxation announced at budget.
“Strikes are hugely disruptive for patients and put pressure on other NHS staff. We’ve been engaging with the BMA Consultants Committee on their concerns already and stand ready to open talks again – we urge them to come to the negotiating table rather than proceeding with their proposed strike dates.
“We urge the BMA to carefully consider the likely impact of any action on patients.”
It comes as Keir Starmer signalled Labour could overrule pay bodies’ recommendations on public sector pay.
Rishi Sunak has indicated the Government might ignore independent experts’ suggestions for lifting workers’ wages.
Asked about Labour's position, Mr Starmer told the New Statesman's Politics Live Conference: "If we are privileged enough to come into power at the next election ... we're going to inherit a real mess - a very badly damaged economy, public services that aren't on their knees but are on their face, the NHS in particular, and a sense that we've got to go at pace to try and repair and rebuild, and run towards the future which is available for us as a country.”
He stressed that the party would keep a firm grip on the country's finances, saying that its "strong fiscal rules" could not be broken when paying for public sector improvements.
Mr Starmer also accused the Prime Minister of being "out of touch" after Mr Sunak told struggling Brits to "hold their nerve" over interest rate hikes.
"Some of the language he has used in the last week has been extraordinary: 'I'm on it', 'Hold your nerve', or recently telling the country to 'understand the economic context'," he said.
"The idea that people who are struggling every day do not understand the economic context they are in is, frankly, real evidence of how out of touch he is."
