Junior doctors’ strike: NHS England to gather information on service impact

NHS England has said it will gather information on whether refusals by the BMA to recall striking doctors to work has affected services.

Junior doctors in England began a six day strike—the longest single walkout in NHS history—at 7 am on Wednesday 3 January.

On 4 January NHS England wrote to the BMA to respond to concerns raised by the union that NHS England and some NHS trust were undermining the process for recalling striking doctors, called derogations.1 NHS England said that during the industrial action its priority was to support local leaders to do whatever was necessary to maintain safe care for patients and that the process for submitting requests for patient safety mitigations (derogations) was a “critical component of this.”

It said it was “regrettable” that the BMA had questioned “the integrity and motive of local clinical leaders—some of whom are likely to be BMA members—who are requesting patient safety mitigations on behalf of their services, the staff who are working within them, and the patients who need them.”

NHS England said that the BMA had received more requests for junior doctors to be recalled than in previous rounds of action because of the time of year and the length of the action, “as well as the fact that the impact of industrial action on NHS services and patients has continued to grow with each action (including those called by other unions).”

NHS England said that it would make changes to how it dealt with the derogation process. This included following up with trusts that had derogation requests either rejected by the BMA or not considered in a timely fashion, “to compile a picture of the impact this has had on services.”

NHS England will also “reinforce the extant requirement for providers to record any patient safety incidents, and to specifically report those which occur during periods of industrial action to regional teams, so that we can evidence harm and near misses which might have been avoided.”

It asked the BMA to consider committing itself to providing a decision on each patient safety mitigation request by the deadline stated by local leaders and to expand the committee that considers requests to ensure it had input from BMA members with experience of clinical leadership in trusts.

NHS England also asked the BMA to consider allowing local medical leaders the opportunity to put their case directly to the committee when their application for a patient safety mitigation was being considered.

The BMA has granted a derogation for one junior doctor to work on the neonatal unit at University Hospital Lewisham for the day shift on 5 January. “The trust have informed us that alternative sources of staffing have been exhausted,” the BMA said. “Our priority is patient safety.”2

A BMA spokesperson said the association was considering the letter.