A number of junior doctors in Cumbria are taking part in a national 48-hour strike.
It's the latest in an ongoing row with the government over new contracts, however, the local NHS board say that very few patients will be affected.
Some Cumbrian NHS staff are beginning the first of four days of working to rule following yesterday's strike.
Nurses and midwives are among those taking part in the protest over pay.
The unions want all NHS staff to receive a 1% pay award but the government says they can't afford it.
Workers represented by six unions were involved in the four hour stoppage this morning. They are fighting for a 1% pay award for all NHS staff. Urgent and emergency care was unaffected - unions say that some appointments and operations were disrupted.
Kim Inglis reports
Cumbrian NHS staff have joined pickets outside the region's hospitals in a national strike over pay.
Ambulance workers, nurses and midwives were among those from 6 unions taking part in the 4 hour stoppage between 7am and 11am.
The unions want a 1% pay rise for all NHS staff but the government says the organisation just can't afford it.
Today's strike will be followed from tomorrow by four days of working to rule.
Some staff are due an incremental pay rise but the unions say this is not a pay award but a contractual right.
Emergency services continued as normal during the strike action but some appointments and operations were expected to be postponed.
Health unions are due to go on strike for four hours across Cumbria this morning.
The NHS says organisations in the county are working together to ensure the disruption will be kept to a minimum, although some services will inevitably be affected, in particular the North West Ambulance Service.
The Scottish Government has estimated that around 1,283 workers from its core and main agencies are on strike, equating to around 18% of Government staff.
A spokeswoman for the Government said:
"Main Scottish Government and agency buildings have remained open and arrangements are in place to ensure essential business continues."
BBC journalists in Cumbria and southern Scotland have walked out in a row over jobs.
It's part of a national day of action in protest at compulsory redundancies nationally, mainly affecting BBC Scotland, 5live and BBC Asian Network.
Around 20 National Union of Journalist members at BBC Cumbria and Look North in Carlisle are taking part.
Staff in Selkirk in the Scottish Borders are also taking part.
Trains across Scotland will operate as normal in the run up to Christmas, after ScotRail announced the strike was off.
RMT union members and ScotRail have previously failed to reach an agreement over the sacking of a colleague.
They were planning on striking on December 22nd and Christmas Eve.
"The RMT strike is off+dispute is over. Trains will run as normal this Christmas. Thanks to customers for your patience in the last week"
Strikes by ScotRail workers will go ahead in the run up to Christmas.
The two 24-hour strikes will take place on December 22 and Christmas Eve after a dispute over the sacking of an employee.
Members of the Rail Maritime and Transport union are warning of "massive disruption" to services.
ScotRail says trains will still run on strike days but called the disruption a "clear attack" on the travelling public.