Consultants in England who returned to the picket line on Thursday for a 48-hour stoppage have said it is “not part of our DNA to be on strike” but insisted they will not back down in their pay dispute. As with previous strikes, they are operating “Christmas Day” cover, meaning emergency care will be provided until they return at 7am on Saturday. The British Medical Association (BMA) is planning another two days of industrial action by senior doctors in September and a three-day strike – the longest yet – in October if the government continues to refuse more pay talks. And junior doctors are due to vote next week on extending their industrial action for another six months. Speaking on a picket line outside Leeds general infirmary, Tracy Jackson, a consultant gynaecologist and BMA strike supervisor, said: “Our passion is looking after patients. I went to medical school 40 years ago and it’s not part of our DNA to be on strike. I’m a surgeon, not a politician, and I just have to keep trying. This is the one way that we have because we have to make a stand and try and make our voices heard and this seems to be the only way, so we’re going to keep going.” She said she was worried about recruitment and retention of staff, having seen some colleagues “decide to do other things, work in other countries or leave medicine altogether”. NHS vacancies have started rising again, heaping more pressure on to trusts as they struggle to cover the industrial action. Figures published on Thursday showed that in the three months to June, NHS vacancy rates increased by 11.6% from the previous quarter to 125,572, although this was more than 5,000 fewer vacancies than at the same time last year. Saffron Cordery, the deputy chief executive of NHS Providers, said of the figures: “The NHS still faces severe staff shortages amid ever-growing demand and the knock-on effects of months of strikes. Recent months have seen an increase in unfilled posts across the health service. “The long-awaited new long-term workforce plan for the NHS must put staffing for health services on a sustainable footing by boosting recruitment, retention and training. But right now trusts and stretched staff face relentless pressure as they tackle record-high waiting lists and work flat out to see more patients more quickly.” Outside Newcastle’s Royal Victoria infirmary, Dr Gill Turner, a consultant paediatrician, told ChronicleLive she was striking over working conditions as much as pay. “We are working in a system as a whole where the whole system is underfunded – it’s broken. I feel that I can’t deliver the care I want. If I was 20, 25 now, I’m not sure I’d choose to do this,” she said. “We are not going to get the best young people coming into medicine. This is not just about consultants’ pay. It’s about how can we ensure the NHS is able to provide the brilliant care we came into this field to provide.” NHS England expects the number of appointments and operations cancelled or postponed as a result of industrial action across the NHS since December to soon surpass 1m. The action is estimated to have cost the health service about £1bn. NHS England said industrial action near the August bank holiday would put even greater pressure on the health service as many staff are on holiday. NHS England’s national medical director for secondary care, Dr Vin Diwakar, said almost all routine care would be affected and there was “no doubt that it becomes harder each time to bring routine services back on track” after nine months of strikes. In July, Rishi Sunak announced that pay negotiations had ended and that consultants would receive a 6% rise. The BMA says consultants’ take-home pay has fallen by more than a third in 14 years.