Consultant industrial action: SAS guidance

Guidance for SAS doctors working during consultant industrial action in the NHS in 2023. 

Location: England
Audience: SAS doctors
Updated: Wednesday 4 October 2023
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SAS doctor action

SAS doctors are not able to take part in consultant industrial action as they are employed on SAS contracts so must attend work as normal.

Christmas day service

The BMA has been clear in the run-up to its ballot that they intended ‘Christmas day’ levels of care as the form of industrial action they would take. This means that emergency care will continue to be provided, but elective/non-emergency work will need to be cancelled. Employers have been given advance notice of the dates of industrial action. This means there has been ample time for all planned activity to be cancelled in advance and to minimise disruption to patients.

Acting-up/providing cover

Formal arrangements

It is unlikely that formal acting-up arrangements will be put in place for SAS doctors during consultants’ industrial action.

It is unlikely especially when planned action by consultants will only be relatively short (i.e. two days). Please bear in mind:

  • The 2008 contracts for both specialty and associate specialist doctors stipulate a minimum 14 days qualifying period before individuals can be paid for acting-up (in the arrangements set out under Schedule 28)
  • The 2021 contracts for specialty and specialist doctors explain individuals would not normally act up (in the arrangements set out under Schedule 19) for a continuous period of less than a month (unless mutually agreed)

Providing cover in an informal capacity

It is possible that SAS doctors will be asked to provide cover in a more informal capacity. The 2008 Specialty Doctor and Associate Specialist contracts, as well as the 2021 Specialty Doctor and Specialist contracts, state that individuals “will be expected to be flexible and to cooperate with reasonable requests to cover for their colleagues’ absences where they are safe and competent and where it is practicable to do so” (Schedule 3, paragraph 3). The emphasis on safety and competency is paramount: SAS doctors are also under the GMC obligation not to work outside their competency.

Your NHS employer may request that you provide cover for absent consultant colleagues on the day of industrial action, provided you have the clinical competencies to do so.

What you'll need to consider

If you are asked to cover for absent colleagues, you will need to consider:

  • If you are capable of providing this cover
  • If, outside of your own personal capability, it is safe to provide this cover (as both your own and supporting services are likely to be severely disrupted by consultants’ absence – see below)
  • If this cover will adversely impact your job plan (as where cover adversely impacts your job plan and/or opportunities, a temporary job plan will be agreed for the period of cover)

Both 2008 and 2021 contracts underscore that, should providing cover be impracticable, the employing organisation will be responsible for sourcing alternative cover. The SAS doctor, however, has the responsibility of bringing the need for this to the employer’s notice.

SAS doctors must not be pressured into covering consultants, especially if they have concerns around patient safety. If you feel you are being pushed to do so, contact the BMA by calling 0300 123 1233.

If you do cover a colleague, we would advise that you get the informal cover arrangements put it in writing, so there can be no disputes after the action ends.

Compensation for providing cover

As explained above, while a temporary job plan can be drawn up for temporary cover, SAS doctors are unlikely to get acting-up payments or access the acting-up allowance for work undertaken during the consultants’ industrial action.

However, when SAS doctors work outside their contracted hours they should receive either an equivalent off-duty period or remuneration. We would advise members to utilise the BMA SAS doctors extra-contractual rate card for these purposes. Members may also wish to check with their LNC chair to see if there are any agreed rates in place in their trust for SAS doctors undertaking extra-contractual work.

Delivering a safe service

SAS doctors who work autonomously

If you are a SAS doctor who works autonomously, and activity is listed under your name, it is possible your trust will ask that this activity goes ahead during the industrial action. As an autonomous practitioner you would be contractually obliged to provide this service as long as it is safe to do so.

SAS doctors who do not work autonomously

If you are a SAS doctor who does not work autonomously, you should not be asked to work without consultant supervision.

Elective or non-emergency work

For any elective or non-emergency work to go ahead on the days of action, 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 cover, and subsequent risks.

Patients undergoing surgery or an invasive procedure should be appropriately consented and informed that the consultant strikes are occurring and there will be reduced support available in the event of complications.

Raising concerns

If you do not think your service can run safely, either because consultant supervision will not be in place, or because other services – such as radiology or pathology – will not be functioning as usual, you have a duty to make this clear to your employer. We also ask you to raise the matter with the BMA by calling 0300 123 1233 if you are being pressured to work without adequate supervision, or outside of your competencies, or in an environment you believe is unsafe.

Cancelling leave

Employers should only cancel leave as a last resort

Employers have had advance notice of strike days and should make arrangements which don’t involve cancelling annual leave to ensure continuation of services to patients. As such, it should not be necessary for employers to try to cancel your leave. As above, there may be limits to the work that you are able to deliver on days of action anyway, in which case cancelling leave would be largely self-defeating.

Seeking to cancel annual leave should be a last resort only after all other options have been considered and exhausted. If your employer seeks to cancel pre-booked leave, you should get in touch with BMA advisers directly on 0300 123 1233.

Employers can cancel pre-booked days of study leave to meet service requirements

However, an employee who has their study leave cancelled has a good argument for asking for reimbursement of any reasonable losses they suffer. As above, this should only be considered as a last resort after all other avenues (such as cancelling routine activity) have been exhausted.

SAS pay campaign

While SAS doctors cannot take part in this round of industrial action, we are aware that members have concerns about their pay, and UK SAS committee are committed to addressing these.

The BMA’s UK SAS Committee is in the process of entering discussions with the DHSC to ensure SAS doctors are valued appropriately.

Read more.

Still have questions?

If you have any other questions about how the consultant industrial action will affect your personal situation (for example, if you are on a contract separate to the ones mentioned above), please get in touch with the BMA directly.