Once industrial action is underway, and resident doctors are on picket lines, there may be occasions when it becomes necessary to recall doctors to help with extraordinary events. A derogation request process has been agreed whereby, in the event of a mass casualty incident, NHS employers may contact the BMA and seek agreement to recall striking staff.  

What is a mass casualty event?

The BMA has decided not to strictly define a mass casualty event, given that it may present differently in different contexts. Scottish Government defines a mass casualty incident as “a disastrous single or simultaneous event(s) or other circumstances where the normal major incident response of several NHS organisations must be augmented by extraordinary measures in order to maintain an effective, suitable and sustainable response”. For mass casualty events, a rapid response protocol is agreed which will seek retrospective rather than prior approval for striking doctors to return to work.

How are derogations agreed?

Derogations will first need to be agreed by the BMA at a national level. If there is a derogation at your department or NHS Board, you’ll be asked to return to work by your Board and we will confirm this on BMAScotland X and our strike action toolkit as soon as possible. Please always check for a verification from the BMA.

Returning to work because of a derogation

Resident doctors on strike should not be asked to return to work unless we confirm a derogation. We have agreed with NHS Scotland a failsafe bypass mechanism only where a massive, externally declared event occurs which requires the urgent return of resident doctors. In these exceptional circumstances the Board may ask you to return to work in parallel with central escalation to NHS Scotland and the BMA. This should be exceptional, will be audited, and will be subject to review of our arrangements in future industrial action.