The last time doctors decided to take industrial action was in 1975. Almost four decades later, it has taken a row over pensions to prompt members of the British Medical Association (BMA) to call on its members to only provide emergency or urgent care on Thursday.

In East Anglia, primary care trusts say it will be 'business as usual' for most GP surgeries, with only a few expected to be offering just emergency or urgent cover, while some hospital services could also be affected.

David Kerry, head of emergency planning for NHS Norfolk and Waveney, said so far the indication was that all GP practices in Norfolk and Waveney would be open for their normal surgery hours, but some would be modifying what services are available.

He said: 'We are currently seeking responses from 117 main GP practices. Ninety-four practices have responded and we know 66 practices are taking no action at all with twenty-eight modifying some services, but this ranges from virtually no impact to a handful offering urgent and emergency appointments only. Only a small number of routine appointments and administration will be affected.'

For example, a snapshot survey of the Dereham area showed that medical centres at Litcham, Elmham and Swanton Morley, Fakenham, Massingham, Wells, Burnham Market and Docking, Swaffham, Reepham and Mattishall will have clinics as normal and GPs will be conducting a normal surgery.

At Dereham's Theatre Royal Surgery, three of the partners who are normally on duty on Thursdays will be seeing emergencies and visits only, while another partner who is normally on duty that day will carry out normal booked surgeries and visits. The surgery nursing, administrative and management teams are all working as normal.

Richard Hall, practice manager at the Orchard Surgery in Dereham, said: 'Whilst we support the reason for the action, we have taken the decision not to inconvenience our patients and will be offering a normal service.'

In local hospitals, all urgent and emergency care will be provided as normal, including maternity services. Earlier this week, indications were that all routine services at The Queen Elizabeth Hospital King's Lynn were expected to proceed as usual and at the James Paget University Hospital in Gorleston and the Norfolk and Norwich University Hospital a very small number of clinics or routine operations may have to be re-scheduled.

For Rob Harwood, a consultant in anaesthetics at the N&N, the decision to strike was not taken lightly, but it is the unfairness of the pensions changes proposed which mean he will only be offering a clinic for urgent and emergency cases tomorrow.

Dr Harwood, chairman of the Eastern region consultants' committee of the BMA, said the changes to pensions agreed four years ago made them fairer and ensured that the scheme was already future-proofed and would not fall upon tax payers if costs rose.

He said: 'The NHS pension scheme makes a �2bn a year profit for the treasury already.

'These changes mean that civil servants would be paying about half as much for the same pension as doctors on the same salary and it simply isn't fair that one group of public sector workers would be paying twice as much as another.'

He added: 'Patient safety will be the absolute priority despite the strike. All doctors will be going into their normal place of work.'

In Suffolk, 22 out of 68 GP practices will be affected by industrial action, although in seven of these practices not all GPs are participating.

Sadie Parker, NHS Suffolk's head of primary care, said: 'Plans are in place to ensure patient safety and quality of care is not compromised on Thursday.

'For the majority of GP practices in Suffolk it will be business as usual. However it is common sense that everyone needs to think carefully about how they use NHS services on Thursday and lighten the load on the NHS.'

People who have appointments already booked should assume these are proceeding unless they are contacted by their GP or hospital practice and told otherwise

On Thursday, people who feel they need to see a doctor urgently should contact their GP surgery as normal. The out-of-hours GP services, as well as community and mental health services are expected to operate as usual.

People are also being encouraged to first seek advice from their community pharmacists, who are highly qualified and can offer advice and medicines for many health issues.

A spokesman for the Norfolk and Waveney Local Medical Committee, which represents GP practices, said: 'Individual practices will decide whether they undertake routine appointments. Patient safety continues to be doctors' priority, regardless of whether nor not they are taking industrial action, and all affected practices will have taken steps to ensure this is not compromised.'