Rotorua Hospital is again set to be affected by strike action, with resident doctors planning to walk off the job for the second time in just over a month.

Members of the Resident Doctors Association will strike for 48 hours, starting at 7am on Wednesday, November 23.

Last month more than 50 elective procedures were postponed, as well as several outpatient clinics, when junior doctors went on strike for 48 hours.

The union and DHBs have been in dispute over hours of work and rosters.

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Lakes District Health Board communications officer Sue Wilkie said the board had not yet received formal confirmation of the strike notice.

Until that was received she would not comment on preparations for the strike, including whether elective surgeries and clinics would be postponed.

During last month's strike just under two-thirds of Rotorua Hospital's 75 junior doctors walked off the job.

The union's national secretary, Deborah Powell, said the legally required 14 days of notice was being sent to District Health Boards today.

Her announcement came after the DHBs said their "world-leading offer" was rejected by the union in mediation yesterday. Dr Powell said the offer was not as good as stated by the DHBs.

The new strike by resident medical officers follows one of 48 hours by the union on October 18.

The dispute was at first over the union's demands for safer working hours and its assertion that long hours were putting patients and doctors at risk.

But after the DHBs agreed to safer rosters without paying for the resulting days off, the row took on a pay element too.

The DHBs gave details of their latest offer, including: a 5 per cent pay rise over three years, and a payment of $200 when working a weekend shift.

The 20 DHBs expected their offer to settle the dispute because it addressed all the health and safety issues the union had raised and offered the $200 payment.

Dr Powell said the 5 per cent pay-rise offer was no better than what other health workers were receiving except that it was over a longer term.

- Additional reporting NZME