LONDON (AP) — Thousands of senior doctors in England began a 48-hour walkout Thursday to demand better pay and conditions, paralyzing hospitals and leaving only emergency care covered.

The severe disruptions are the latest in months of industrial action by public sector workers amid UK’s ongoing cost-of-living crisis. They come just two days after junior doctors staged the longest strikes in the history of the state-funded National Health Service.

Thousands of operations and appointments have been cancelled, and health officials say the impact of the latest round of strikes to hit the country’s public health system is likely to be the biggest yet, because almost no work can be done at hospitals unless it’s supervised by a senior doctor.

Senior doctors, known as consultants in the UK, will only be “on call” for urgent work such as critical cancer care until Saturday morning.

The Conservative government has offered a 6 per cent pay increase to the doctors, but the British Medical Association, the doctors’ union, called this “derisory.” It said doctors have seen real-term take-home pay fall by more than a third over the last 14 years, and accused authorities of refusing to engage in negotiations on pay.

Union executive Dr Vishal Sharma said that many in his profession felt “undervalued and overworked.”

“Consultants will stand on the picket lines today, because we are angry and at rock bottom. We never wanted to be forced into taking this huge step,” Sharma said. “Ministers have done absolutely nothing to stop this action taking place.”

Nurses, junior doctors and emergency health care workers have all joined public sector strikes in recent months to demand better pay to cope with soaring food, energy and housing costs. Inflation in the UK stood at 7.9 per cent in June, down from double digits earlier in the year, but it’s still far higher than other Group of Seven economies.