Key points for resident doctors

• You should attend work as normal if you are rostered to work during consultant and SAS doctor industrial action.
• You do not need to work additional hours on consultant and SAS doctor strike days.
• You should not be expected to deliver routine, elective or non-urgent activity without appropriate consultant or autonomous SAS doctor supervision.
• You should not work outside your competence, experience or level of training.
• You should not be asked to “act up” into a consultant or autonomous SAS role where appropriate supervision is not available.
• If you are a resident doctor already “acting up” you should only do so with appropriate supervision in place. 
• If safe supervision is not in place, the relevant clinical activity may need to be cancelled, postponed or escalated locally.  This is the responsibility of the Trust to organise.
• If you experience pressure to undertake unsafe work, that you consider is outside your competency area, training or experience, keep a written record and contact the BMA for advice.

Attending work during consultant and SAS doctor action

If you are rostered to work, you should attend your shift as normal. However, the work available to you may be different from usual because services that rely on consultant or autonomous SAS supervision may be cancelled or rescheduled.

Where scheduled activity has been cancelled because senior supervision is not available, you should not be expected to fill that gap by undertaking work that would normally require consultant or autonomous SAS input. Employers should plan services on the basis that Christmas Day cover is in place and should not rely on resident doctors to maintain routine or elective activity without appropriate supervision.

Supervision and safe working

Resident doctors must have access to appropriate clinical supervision. If your usual supervising consultant or SAS doctor is taking industrial action, the employer should identify who will provide supervision and clinical responsibility during the period of action.

Before undertaking clinical work that requires senior input, you should be clear who is supervising you, how they can be contacted, and whether they are available in person or remotely. If this is unclear, ask your rota coordinator, clinical lead, site manager or another appropriate senior manager to confirm the arrangements.

If the required level of supervision is not available, the activity should not proceed unless it can be delivered safely within your competence and with appropriate escalation arrangements in place.

Routine, elective and non-urgent work

Christmas Day cover means that the focus should be on maintaining emergency and urgent care. Routine clinics, elective lists, non-urgent procedures, teaching sessions, audits, governance meetings and other non-emergency activity may not be appropriate during consultant and SAS doctor industrial action, particularly where consultant or autonomous SAS supervision is required.

Acting up and working beyond competence

You should not be asked to act up into a consultant or autonomous SAS role because of industrial action. Any request to undertake additional work must be safe, appropriate to your training and experience, and within your competence.

If you are asked to undertake work you do not feel competent to do, explain this clearly and professionally. You should state what you can safely do, what support you need, and why the proposed arrangement may create a patient safety or professional risk.

If you are concerned about patient safety

If you believe patient safety may be compromised because appropriate supervision is not available, you should escalate your concerns.  This may include speaking to whoever is providing cover, the clinical lead, rota coordinator, site manager, medical director’s office or other relevant senior manager.

Where possible, put your concern in writing or follow up a verbal discussion with a short written record. Keep a note of who you spoke to, when, what you were asked to do, what concern you raised, and what response you received.

If you are unsure what to do, contact the BMA for advice. The BMA will support members who raise genuine concerns about unsafe working, inadequate supervision or pressure to work beyond competence.