In a department where all consultants and/or SAS doctors intend to strike, it is reasonable that whoever is currently scheduled to provide the on-call/emergency cover on the strike days continue to do so. However, if the consultant or SAS doctor currently scheduled to be on-call on those days intends to strike but other consultants or SAS doctors in the department are not intending to do so or are not eligible to strike, it would be appropriate for the Trust to reach agreement with non-striking consultants or SAS doctors to provide the emergency cover.
To support the above planning, the BMA encourages members to have discussions with department colleagues to ensure emergency cover is in place and to share the outcome of these discussions with employers.
As this action will last 24 hours, it is anticipated that any activity that would not normally take place on Christmas Day, or does not meet the definition above, would be rescheduled to either side of this strike date. This would be common practice for Public Holidays that fall mid-week during the year.
Given that in almost all cases, clinical activity cannot go ahead in the hospital without the presence or supervision of a consultant or autonomously practicing SAS doctor, even if that supervision is remote, this strike is likely to significantly impact upon elective, non-urgent or non-emergency work.
The BMA has advised members that elective activity should not be scheduled for the strike days. Trusts should work on the basis that staff taking strike action (or providing emergency cover for those taking strike action) will not support scheduled activity.
It will be important for systems and Trusts to plan for the entirety of the cumulative period of disruption (both the action on 25th June, and the subsequent action on 29th June for resident doctors). Every effort should be made to ensure that urgent elective surgery (P1 and P2), cancer care (particularly for patients who have already been waiting over 62 days, or who are likely to pass day 62 if their appointment needs to be rescheduled), and long waiters experience minimal disruption to their care.
During previous periods of industrial action Trusts have tried to maintain as much planned and elective care as possible. However, action by consultants and SAS doctors brings different challenges around safe delivery of activity. Whilst there may be consultants and SAS doctors who choose not to or who are not eligible to take strike action, it is important that Trusts and staff work across teams to take a whole pathway approach to determine what, if any, elective activity can safely go ahead, particularly for surgical or other procedures.
For any other non-emergency work to go ahead, a full risk assessment would be required in advance on a case-by-case basis. This would need to include an assessment of the support specialities that may be required should a complication occur, the availability of the cover and subsequent risks. Any patient undergoing any procedure on the strike day should be appropriately informed of the reduced level of cover at the point of consent. This risk assessment should be documented for the proposed activity, including which consultants and/or SAS doctor would be providing this cover. Trusts should not plan activity on the assumption that the emergency cover consultant or SAS doctor will provide cover as the
BMA are clear that the derogation allowing emergency care to continue only extends to services that would run on Christmas Day.
The consultant and SAS strikes are different to previous rounds of industrial action involving other staff groups. No other worker can provide cover for consultants or autonomous SAS doctors, and other staff groups are dependent upon supervision from consultants or autonomous SAS to be able to work. Almost no activity in a hospital can occur unless it is listed under and supervised by a named consultant or autonomous SAS doctor. Resident, Locally Employed, locum doctors and non-medical staff should not be put in a position where they are asked to perform elective work where this is not under the direction of a named consultant / autonomous SAS doctor or outside of their competencies. If such activity goes ahead appropriate consultant or autonomous SAS doctor support must be available and this must be provided by a consultant/ SAS doctor other than the on-call consultant / SAS doctor.