It is the longest-running and most acrimonious pay dispute in England's National Health Service (NHS), which has led to hundreds of thousands of operations and appointments being cancelled.

Then came the sudden news on Monday that the British Medical Association was advising its 50,000 junior doctor members to accept the new government's new proposals.

This sounds too good to be true. Now some are wondering if it's possible.

On Friday, just three days after formal talks began at the Department of Health's London headquarters, Health Secretary Wes Streeting laid his cards on the table.

He made it clear to the British Medical Association delegation that this was a final proposal - an average pay increase of more than 22% in the UK within two years.

The union team said they wanted to consider the issue over the weekend. On Sunday, BMA junior doctors' leaders met and decided that, while it fell short of their demand for a 35 per cent pay rise, it was the best deal they could get.

A huge boost from the government - Chancellor Rachel Reeves paid tribute to the job done by the Health Secretary when she appeared in the House of Commons.

Mr Streeting met with BMA joint junior doctors leaders Dr Rob Laurenson and Dr Vivek Trivedi on several occasions before the election and asked them in a final meeting on Zoom to call off the upcoming strike ahead of polling day.

When Streeting was appointed health minister, he immediately called the BMA for talks. Within 10 days of their appointment, two meetings were held with Dr. Laurentian and Dr. Trivedi before formal salary negotiations began.

The Health Secretary is helped by the fact that the Independent Pay Review Body's recommendations for pay rises in 2024-25 have just arrived on his desk, recommending a 6% pay rise and a one-off payment of £1,000.

That allowed him to make an offer that effectively combined two years of raises. He added 4% to last year's pay awards - which were worth almost 9% on average - and agreed with the pay review body's recommendations for the current financial year.

In less than a week of talks, the new health minister has achieved what the previous government failed to achieve during 11 strikes over the past 18 months.

“The important thing is that this can be presented as a win-win for both parties,” said a source with knowledge of the negotiations.

"The BMA got a big figure while the government only got 4 per cent extra pay rises over two years than the pay review body recommended - just one percentage point more than what the Conservatives proposed when talks collapsed in December."

Ms Reeves defended the deal, saying the cost of around £350m was "a drop in the ocean" compared with the £1.7bn cost of the NHS strike.

This may all be true, but services for junior doctors are not neglected elsewhere in the NHS.

This year's funding budget for the health service includes a pay rise for NHS staff of just 2%.

The Treasury Department said it would cover some of the additional costs, but possibly not all. This caused concern among senior hospital managers.

Nick Hume, boss of Ipswich and Colchester hospitals, said: “Unless we receive additional funding to pay for this pay rise, we will have to deduct money from services which will have a huge impact on the hospitals we serve. It’s inappropriate for people.”

Other frontline workers are also frustrated, having to scrape by. Staff such as nurses, midwives, paramedics and physiotherapists saw increases of just over half that of junior doctors.

The Royal College of Nursing (RCN) said it will now consult its members to find out what they want to do and has not ruled out the possibility of industrial action.

RCN leader Professor Nicola Ranger said: "We will not begrudge doctors a pay rise. "We demand the same fair deal from the government."

Professor Len Shackleton, an economist at the University of Buckingham and a fellow at the Institute of Economic Affairs, believes this may be just the beginning of a new round of demands for pay rises.

"It would be naive of the government to think it's all over - other unions will look at this deal and think they can get more, not just unions in the NHS but unions across the public sector. That could be out of control."

GPs launched a working rule on Thursday over what they said was underfunding of GP practices - although the vote that led to the outcome took place before the junior doctors deal was announced.

And there are already signs that junior doctors themselves will be back asking for more.

In a WhatsApp message leaked to The Times, Dr Laurentian said there would be another "window of opportunity" for further strikes in 12 months when the new government's honeymoon period ends.

He said he was "desperate" to get more from ministers but this was the best that could be achieved at the moment. When the story came to light, he told X that he told Mr Streeting the same thing in person during the meeting.

The end of the NHS labor dispute may not be as close as it first seems.

Above: Getty Images

BBC in-depth report is the new home of websites and apps delivering the best analysis and expertise from our top journalists. Under a unique new brand, we'll bring you fresh perspectives that challenge assumptions and in-depth coverage of the biggest issues to help you make sense of a complex world. We'll also be showcasing thought-provoking content from BBC Sounds and iPlayer. We start small but think big, and we want to know what you think - you can send us your feedback by clicking the button below.