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The dispute surrounding the junior doctor contract is a rapidly developing situation within a complex legal framework, so we will continue to update these FAQs as soon as we can.
For legal reasons, there are some questions around the ballot and possible industrial action that we cannot provide answers to at this stage.
What is the dispute about?
In 2012 the Government asked the BMA to look into negotiating a new contract for junior doctors. After 2 years of negotiations, the BMA withdrew from the table because the contract on offer would not have provided sufficient safeguards for junior doctors and their patients – either today or in the future.
The Government asked an independent body (the DDRB) to undertake a review and provide recommendations for a new contract. After the recommendations were released the Government asked the BMA to re-enter negotiations with the recommendations as the basis. We could not agree to that and so the Government said they would impose a new contract from August 2016.
We cannot allow a new contract to be imposed which would be bad for doctors, patients and the NHS.
You can read further background information including the recommendations, the analysis of the recommendations and how we've got here.
Read more about how we got here What are the Government's plans for imposition of a contract?
On 4 November 2015, the government released its contract offer, which it intends to impose on junior doctors in England, from August 2016. The contract is not substantially different to the recommendations from the DDRB.
Read the full contract offer here, as well as the BMA response to this latest contract offer.
Who will have the contract imposed on them?
The government have told us that it will impose the contract on all junior doctors in England from August 2016. Why don't we just negotiate a new contract?
The BMA remains committed to genuine and meaningful negotiations for a safe and fair contract, but this can only be achieved if we are provided with the following concrete assurances we have consistently asked for and the threat of imposition is removed.
Has the BMA sought legal advice about whether the Government's imposition is legal?
We have sought extensive legal advice. It is legally possible to impose a new contract. Why does the BMA say that the proposed contract changes risk patient safety?
The removal of safeguards on hours risks exposing patients to doctors working dangerously long hours. Unsafe working practices risk patients' lives.
What does the BMA hope to achieve from industrial action?
We want a safe and fair contract for junior doctors. To do this we need to robustly resist an imposition of a contract that is unsafe for patients, and unsafe and unfair for doctors.
For many years the contract has been arrived at by a process of negotiation, which is what should happen here. We need to ensure that the contract junior doctors have for the next ten years is appropriate.
Why are Scotland, Wales and Northern Ireland not included? The Scottish government has stated that they would not impose a contract on junior doctors and instead would talk to BMA Scotland to decide how to move forward (maintaining the existing contract in the meantime). The Welsh government followed suit a few days later. The Northern Ireland health minister, Simon Hamilton, has said he has “no desire” to impose the junior doctor contract and an imposed contract would be the “worst possible outcome”. BMA will be meeting with the Minister and his officials to discuss how we can work together to resolve the situation.
If I am not a member, can I take action?
Non-members who take part in any action do so at their own risk and under their own authority. The BMA will only be calling upon members to take part in any industrial action, and their non-member peers would not receive support from the BMA if any action was taken against them by the employer.
We would advise that you join up so that you receive the protection as well as support available to trade union members. If I join the BMA, can I take action?
Yes. I am a clinical academic, can I take action?
Those with an additional contract that is with a non-NHS employer will not legally be able to take action against that other employer - so you will need to think about your particular situation on the day(s) of action. I am a GP trainee, can I take action?
Yes, all GP trainees can take action. This includes those with a single lead employer contract, those who hold a contract directly with a GP practice, and those who have both. This is because they are all included in the trade dispute and will be affected by the imposition. I am a public health trainee, can I take action?
Those with an additional contract that is with a non-NHS employer will not legally be able to take action against that other employer - so you will need to think about your particular situation on the day(s) of action.
I'm employed by the armed forces, can I take action?
No. If you are solely employed by the armed forces you are legally not permitted to take part in industrial action. I work as a NHS hospital locum junior in England, can I take action?
Yes. You can take action. I'm a trust grade junior doctor in England, can I take action?
Yes. You can take action. I'm an overseas junior doctor working in England on a visa, can I take action?
Yes, you can take action if you are an overseas junior doctor, provided that you have a current contract with an NHS employer in England. If you are working in the UK under a Certificate of Sponsorship from a licensed sponsor employer you would need to consider the impact that a period of unpaid leave or a reduction in your pay would have on your sponsorship. If you are employed under a Tier 2 (General) Certificate of Sponsorship it is unlikely that any period of unpaid leave would affect your status as your sponsor is only required to report unauthorised absence (such as industrial action) if it continues for more than 10 consecutive days. As a Tier 2 sponsored worker however, you cannot be absent from work without pay for more than 30 days in any 12 month period. If you have already taken a period of unpaid leave for other reasons (not including leave of a permitted type, such as maternity or long term sickness), you will need to consider your own position as to whether your participation in industrial action may take you over the permitted threshold. Your sponsor may be required to report a temporary reduction in salary as part of their duties as a licensed sponsor. This is unlikely to have an impact on your sponsorship.
If any action is taken by your Employer or the Home Office which affects your eligibility to work in the UK, the BMA will support any member who requests it. I'm in my period of grace, can I take action?
Yes. You can take action. I am on maternity leave, sick leave or other type of approved leave; can I take action?
Yes, if you have a current employment contract with an NHS employer in England you can take part in action on the proposed day(s). I’m not on the rota on the proposed days of action, what does that mean for me?
If you are not scheduled to work on a particular day of action, you personally would not need to take industrial action and could not be subject to a deduction of wages on this day. However, you are fully entitled to join in organised activities on the day. What happens if I’m sick on the proposed day(s) of action?
Workers who are absent on sick leave when industrial action takes place retain their right to statutory sick pay during the period of industrial action. If an employee reports as sick on a day of action, the employer can be expected to make their own judgement as to whether the employee should be regarded as on sick leave or taking part in industrial action. Some employers have tried to introduce special rules about sick certificates in the event of sick leave during industrial action – if so, the LNC should inform their BMA Industrial Relations Officer/ Assistant Secretary (IRO/AS) and take the matter up with management as GPs are also likely to be taking action.
It is likely that some employers will say that they can insist on a medical certificate from an individual’s doctor to cover absence on or around the day/s of action as they believe that these are exceptional circumstances. Some contracts do include such a clause. If there is not an expressed provision in contracts then your employer may refer to their own absence/sickness reporting procedures. It is our understanding that these procedures may also have an exceptional circumstances clause.
The planned model of strike action with emergency cover would not apply in my specialty, as nearly all of my work is emergency. What action can I take?
For doctors working in some specialties, such as emergency medicine, your ability to participate directly will be more restricted and you may not be able to participate at all in the emergency care only model of action. However, you will be able to show your support in other ways. We will provide more guidance in due course. What happens if I’m on a shift when the industrial action is due to start – should I just leave?
No. As per the GMC’s Good Medical Practice, you are responsible to effectively handover; effective handover is essential as part of a patient’s continuity of care. If I am an academic clinical trainee and the day of action is the day I am at the university, what should I do?
Those with an additional contract that is with a non-NHS employer will not legally be able to take action against that other employer – so you will need to think about your particular situation on the day(s) of action, and contact the BMA if you need individual advice on this. If I voted 'yes' in the ballot will I have to take part in the action?
The decision to take action is an individual choice, but we would hope that if you vote yes in the ballot, that you are preparing to take action. We encourage members to take action to support the campaign and to support their colleagues. If I voted 'no' in the ballot will I have to take part in the action?
The decision to take action is an individual choice. We encourage members to take action to
support the campaign and to support their colleagues, but we cannot stop you from going in to work on the day(s) of action. What if I didn’t vote for full strike action?
If you voted no you will not be obliged to take part in any action. The decision to take action is an individual choice. We encourage members to take action to support the campaign and to support their colleagues. If I did not return my ballot, can I take part in the industrial action?
Yes. All junior doctor BMA members who have notified us that they hold a contract with an NHS Employer in England (whether solely or in addition to a non-NHS contract), excluding any armed forces trainees.
What form of industrial action is proposed?
We want to do all we can to ensure that employers are able to develop plans to minimise disruption to other NHS staff and patients, so we released the proposed dates, times and type of action on 12 November. What does action look like on those days? Day 1 - 8am, Tuesday 1 December to 8am, Wednesday 2 December 2015: Emergency Care only (8am to 8am)
This is based on what happens in your specialty, in your hospital on Christmas day. If you are down to provide emergency care, then you will remain working. If you are down for clinics,
non-emergency surgery or other non-emergency work then you will not attend work and instead should take part in BMA-planned activity (details of which will follow soon). Day 2 - Tuesday 8 December 2015 and Day 3 - Wednesday 16 December 2015: Full withdrawal of all junior doctors’ labour, 8am to 5pm
This means that junior doctors will not attend work, or provide emergency cover between the hours of 8am and 5pm. Instead you should take part in the BMA-planned activity, details of which will follow soon.
It is important to remember that it is only junior doctors that are taking industrial action and so other doctors and healthcare staff will attend work as normal. Once the BMA has notified the employers that action will be taken, it is the responsibility of the employer to ensure a service is provided.
Detailed guidance about the activities and transfer between work and action, will be released in due course. What are the risks to taking this form of action?
We don’t want to be in this position and nobody takes industrial action lightly.
Patient safety: as the action is being taken by junior doctors, other doctor colleagues (consultants, SAS doctors etc) should be able to run the service for emergency cover. This means that the risk to patient safety is far less than if all doctors were taking action.
In the longer term, this action should provide improved protections to patients, doctors and the NHS once a fair contract is agreed. As hospital doctors we are expected to give six weeks’ notice of cancellation of outpatient clinics. Do we have to abide by the six week rule, would that breach our contractual terms or is it a non-contractual arrangement?
No. The BMA will give appropriate notice to employers in accordance with statutory obligations. It is then the employers’ responsibility to ensure alternative arrangements are made (including cancelling clinics etc). What will happen to my pay if I take action?
Employers will reduce pay for any doctor who takes action for the amount of time they are taking action (eg for one day of action, one day of the monthly salary will not be paid).
It is up to the individual employer how they do this logistically, but it is likely that no matter what type or length of shift you are supposed to be working you will have one day removed for each part of a day you are not working. If you are not rostered to work on the day(s) of action, or if you are rostered for a zero hours day, then you will not have your pay reduced for those days. What will happen to my progression if I take action (ARCP)?
The gold guide says that for anyone who misses 14 days or more of training, in each 12 month period, a review of whether the trainee needs to have their CCT/ CESR(CP)/ CEGPR(CP) date extended will be triggered. What will happen to my continuity of service if I take action?
Legally, any week during which (or during part of which) an employee takes part in industrial action will not count towards their continuity of service. However, any time spent taking action will not break their continuity of service either, so they would retain their current continuity of service regardless of industrial action. Therefore, once you return to work after any industrial action, your continuous service would not be affected, however your employer may reduce your length of service by the number of weeks you took action for. What is to stop the employer from hiring locums to cover the day(s) of action?
The current regulations prevent employers from using agencies to provide cover for those taking industrial action.
Will I be in breach of my contract if I take action?
Yes, those taking industrial action are in breach of their contract. Your employer might send you a letter notifying you of this, however this is just a formality. BMA members receive some protections from unfair dismissal if they take part in legal industrial action. Could I be dismissed for taking part in the action?
The right of an employer to dismiss those taking part in lawful action is restricted. As a general rule, you will be protected from unfair dismissal for taking part in lawfully organised industrial action if any dismissal takes place within an initial protected period of 12 weeks from the first day of the industrial action. Once this initial protected period has ended you are still protected if you personally cease to take any further industrial action. However it is legally possible for an employer to dismiss employees after the 12 week protected period provided that the employer dismisses all those taking part in the ongoing industrial action and does not then selectively re-engage any of these persons within a three month period. This will clearly be very difficult for most employers to do without significant adverse publicity and operational difficulties.
The BMA will support any member who runs into difficulties due to taking action, however we will not be able to support any non-members who run into difficulties. Could I be referred to the GMC for taking part in the action? What is the GMC's view on this model of action?
It is important to be clear about the GMC guidance on the duties of a doctor and that this guidance is not removed or modified by taking industrial action. Have junior doctors taken action over their contract before? What was the outcome?
In 2012 the BMA had a dispute over doctors NHS pensions.
The last time junior doctors as a group took industrial action over the terms of their contract was in 1975. The dispute related to the non-payment of work done outside of the standard 40 hour working week. The action consisted of junior doctors working only the 40 hour week they were contracted to do (at this time 100 hour weeks were common). The Government relented and a new contract was agreed in early 1976. Are consultants, GPs, SAS doctors etc supporting junior doctors in their action?
We understand that many doctors will want to show their support for junior doctor colleagues who are taking industrial action, and we will provide further guidance about doing this in due course. However, the BMA is not balloting these doctors and will not be asking any of them to take part in any industrial action.
It is important to note that your professional responsibilities have not changed and that you will not be acting with the authorisation or inducement of the BMA if you attempt to take any action that can be perceived as industrial action. This could include ‘working to rule’ (working to the explicit terms of your contract) which is a form of industrial action or cancellation of planned patient care aimed to support the action rather than being based on patient safety.
If I have annual leave booked for the day of action should I rearrange this day off to support the strike action?
Hi, that's your decision. Re the FAQs, if you're on approved leave you can take part in the action. Thanks, Kelly
My shift is due to start on 8th December at 4pm. Do I just turn up at 5pm instead?
Could you clarify whether if non-BMA member junior doctor on a training contract decides to strike this is actually legal or does one need to belong to a union to be able to legally strike? Thank you
Industrial action by non-union members.
Non-union members who take part in legal, official industrial action have the same rights as union members not to be dismissed as a result of taking action. (source - www.gov.uk/.../your-employment-rights-during-industrial-action - please click through and read)
This is because it is illegal to discriminate against an employee with regard to their membership (or non membership) of a trade union. An employer is not allowed to ask an employee whether they are a member (or not) of a trade union since this is sensitive personal information. Trade unions have to inform the employer, in an aggregated format, who will be taking part in the industrial action, e.g this number of grades at this work site. As a non union member you will not be included in this aggregated count, so to cover yourself I would advise informing your employer yourself that you will be participating in the industrial action. As I said an employer is not allowed to ask an employee whether they are a member (or not) of a trade union, and personally informing the employer implies nothing since union members are under no obligation to participate in industrial action either. So you informing an employer that you will be participating in a legal industrial action is just you making sure they know, so they can arrange cover etc.
I'm a junior Dr currently locuming through an agency but have a 5 week contract in an NHS hospital this contract falls over the strike dates. Does anyone know if I can still strike? as I am not technically an NHS employee
If you are a BMA member, you receive legal protection in the event of industrial action. We balloted junior doctors who held NHS contracts and met other eligibility criteria - who then voted in favour of IA. More FAQs here bma.org.uk/.../ia-faq
I'm on a tier 4 visa (as is half of my firm)--can we strike safely? You only mention tier 2. Thanks!
My GP practice wants us to cover the on call GP for the emergency cover only strike - they decided this because on Christmas Day they pay an outside provider care UK to cover their patients thereby technically providing emergency cover.
Cont. is this allowed? Could you clarify whether any GP trainee should be at work on emergency strike day?
Hi, you can check our guidance here: communities.bma.org.uk/.../guidance-for-hospital-doctors-gp-practices-and-medical-academics
Hi all the junior doctors who are clinical academics at my University (Cambridge) are being told that they are unable to strike. But they all hold joint honorary contracts of employment with the Cambridge NHS Foundation Trust, and are contracted to provide some clinical services to the Trust. Surely that also makes them employees of the Foundation Trust, and therefore they have the right to strike, providing that the strike day coincides with a day when they are providing those clinical services?
Were Trust grade junior doctors included in the ballot?
We live in a 24/7 society where most employees do not receive overtime rates. Solicitors and accountants do not receive overtime pay. Junior doctors are relatively well paid and have secure jobs and prospects and many will do private work when they reach consultant level and can look forward to bringing in substantially more than £100,000 a year. What justifies them going on strike because of one outstanding issue in their negotiations with GOV...WEEKEND PAY RATES. I think that the selection process to Medical School is a major factor. Many of those entering are not balanced individuals BT have spent too much time studying for their exams rather than learning about the real world. A good exampl of this is that a Foundation doctor mentioned that it was so horrible working in a practice that served mainly a derived community. GET REAL JUNIOR DOCTORS AND APPRECIATE HOW PRIVILAGED YOU ARE! How much longer must I endure pain because my operation has been cancelled? Exam your motives for being a doctor. Which of the following is foremost, STATUS, PAY or PUBLIC SERVICE? Phil Michaels, North London
If as a Staff Grade Registrar I am asked to act as house officer for the duration of the strike am I within my rights to refuse ?