Around 70% of Lincolnshire's junior doctors have joined the pre-Christmas industrial action as they continue to call for pay increases in line with inflation.

The walkout, which began at 7am on Wednesday and is scheduled to end on Saturday, has resulted in United Lincolnshire Hospitals Trust (ULHT) cancelling 99 outpatient appointments and nine elective surgeries on Wednesday alone. But despite these significant disruption, there was no visible picket line outside Lincoln County Hospital.

While some junior doctors say that their profession has suffered a 26% pay cut since 2008, they firmly believe that their value hasn't diminished by a quarter compared to a decade ago. They maintain that their current hourly wage of £14.09 is insufficient, especially in light of the ongoing cost of living crisis.

Discussions were in place regarding a 3% pay rise from January, supplementing the nearly 9% increase junior doctors received in April. Nevertheless, the British Medical Association (BMA) deemed this insufficient, pointing out that junior doctors had requested an additional 35% to compensate for the below-inflation pay rises since 2008.

Groups of young professionals were visible protesting outside Lincoln County Hospital when the first strike began in March. However, attendance began to dwindle over the months, with only two standing in protest during the August action, a significant drop from the original 16. There was no visible picket line on Wednesday, December 20.

The British Medical Association (BMA) claims that its strategy now prioritises larger regional picket sites. Consequently, local junior doctors will be attending strikes in Nottingham and Leicester for this round of industrial action.

A spokesperson from the union said: "Throughout the year, we've moved our focus on to bigger regional picket sites, rather than at every trust, and there are pickets in each region during this round of strikes.

"This approach, where doctors from across each region gather together, makes sense as junior doctors frequently move between workplaces across wider geographic locations. The regional pickets in the East Midlands for this round are in Nottingham and Leicester.

"It's impossible to say how many junior doctors are striking in any given region, as all junior doctors (not just BMA members) are eligible to do so."

ULHT recommends that patients use the WaitLess app to avoid long queues. However, as of just before midday on Wednesday, the longest wait time at Lincoln UTC exceeded three hours. In Spalding, patients faced a wait of two hours and 37 minutes, while in Louth, the wait time was one hour and 59 minutes.

A spokesperson from the trust said: "Due to uncertainty around staffing levels during this time, we have taken the difficult decision to cancel some non-urgent appointments and operations in advance and may need to cancel some appointments at short notice during the strike period.

"Our emergency departments remain open for those who need urgent and emergency care. Our maternity and antenatal services will also be open.

"Using the WaitLess app will help you to avoid long queues if you require urgent care, showing your fastest options for treatment in Lincolnshire."

In the past year, ongoing industrial action has resulted in the cancellation of over 1.1 million appointments and treatments across the UK. This current walkout will precede a six-day strike scheduled for the beginning of January, marking it as the longest strike to date.

Melvyn John Stride, the Secretary of State for Work and Pensions, criticised the striking doctors during his interview with GB News on Wednesday. He urged medical professionals to return to the negotiating table.

He said: "It's deeply disappointing that the doctors have walked away from these talks. We've managed to secure pay settlements now really pretty much right across the rest of the public sector and including agreements within the NHS and other staff that's been put out to balance.

"As you all know, the junior doctors have been holding out for a pay increase that I think was always going to be extraordinarily unrealistic.

"What we are calling on the doctors to do now is to come back around the table so that we can hammer out some kind of agreement and we've already got a pay offer of between eight and about 10% on the table. We're talking about conditions and moving on to that part of the negotiation. But we really do need them around the table because this is going to be a very difficult time.

"That's not to say we haven't geared up for making sure that we can best handle those pressures across the Christmas and New Year. But this is going to be a difficult time. It's unnecessary. And the doctors really should be sitting around the table and negotiate."