What to do on the day

Advance planning

Employers have been provided with six weeks' advance notice of the date of industrial action and the format of this action. This means there has been ample time for all planned activity to be rescheduled in advance and to minimise disruption to patients. 

In order to maintain patient safety in non-elective areas of the health service, ‘Christmas Day cover’ will be provided by consultants and SAS doctors. 

Key points

• Rotas should be constructed using Christmas Day 2025 as the baseline. 
• Different sites and units deliver services in different ways.  

Who should provide emergency cover on strike days?

In a department where all SAS doctors are striking, we suggest that whoever is scheduled to be on-call out of hours on the day of action would typically be the one providing the emergency cover. If you are the on-call SAS doctor it is reasonable for your employer to expect you to be clear about whether you intend to take strike action in order that they can attempt to find alternative cover that will enable you to do so.

If there are SAS doctors in a department who are not striking, and the person who is nominally on-call wishes to strike, they have a legal right to do so. In this circumstance, it remains the responsibility of the employer to ensure that emergency cover is in place, and they should seek agreement with SAS doctors in the department as to how this is provided. Equally, if there are SAS doctors on the rota who are not working that day, it is reasonable for the Trust to explore whether they would be willing to provide cover to enable the rostered doctors to strike.

Providing cover will not attract additional rates of pay if they are undertaken during hours you would otherwise be working if it weren’t for the strike action. Additional work undertaken to provide Christmas Day cover outside of this, including the engaging of SAS doctors who otherwise do not work on the day in question, is extracontractual and BMA rates should be paid. 

Find more details on the BMA’s SAS doctor non-contractual rate card for Northern Ireland. 

Other medical colleagues

Resident doctors are not in the scope of this industrial action. As such, they will need to attend work as normal. Where scheduled services that they would ordinarily take part in need to be rescheduled, there may not be work for them to deliver. Resident doctors should not be undertaking scheduled activity if consultant or autonomous SAS supervision will not be in place. Additionally, resident doctors or SAS doctors who do not practice autonomously cannot be asked to ‘act up’ by their employer, if there will be no consultant or autonomous SAS doctor supervision.

Undertaking additional work in preparation of strike action

Prior to the strikes, Trusts may attempt to schedule additional activity to prepare for days with reduced capacity. This could include the rescheduling of some time-sensitive care, or additional ward rounds to facilitate discharge in order to build capacity for strike days. You may undertake this work if you wish to do so and will be engaged under the normal arrangements for additional sessions. Trusts should offer BMA rates for these shifts in order to ensure that the necessary preparatory work is completed prior to strike action taking place.

Deferring work due to strike action

As a consequence of industrial action, some work will not be done, and some will be deferred. This might include clinical or administrative work and is due to the loss of HSC capacity during industrial action.  You are under no obligation to undertake this work on top of your usual activity, and if you choose to do this please use the BMA SAS rate card. The BMA will support doctors who are asked to make up time lost to industrial action.

Non-clinical activities

These do not constitute emergency care and so, if you are taking part in industrial action, you should not undertake them. Examples would be teaching students, training courses, clinical audit and governance, appraisal or educational supervisor meetings, research, management and administration.

Additional HSC responsibilities and external duties

These do not constitute emergency care and so if you are taking part in industrial action you should not undertake them, unless they are being delivered on behalf of another non-HSC employer (e.g. a university employer). Examples include conducting interviews for specialty training recruitment.

If you're already at work

On this date the industrial action will take the form of strike action for any shifts that are due to start from 7am on Thursday 25 June 2026 until 6:59am on Friday 26 June 2026. 

Industrial action will take the form of strike action for shifts starting between those times. 

For clarity, if the start time of your shift begins before 07:00 hours on Thursday 25 June 2026, the BMA has confirmed that you should commence and complete your full shift as normal. This is in keeping with Good Medical Practice - Professional Standards - GMC.

Further to this, you may find the GMC’s Q&As on Industrial Action helpful.

If you're not scheduled to work

If you are not scheduled to work on a particular day of action are fully entitled to join in organised activities on the day, and we would encourage you to do so. You cannot have your wages deducted on this day either.

You may be asked to undertake the Christmas Day cover to enable your colleagues to strike. We believe BMA rates are reasonable for this cover, which you should consider providing if you are able and it is practical to do so.

Working for a non-HSC employer

If you are scheduled to deliver work for a non-HSC employer on a day of action, you will still need to attend and deliver that work as normal. Non-HSC employers are not covered by this industrial action. This includes, for example, if you are a SAS clinical academic with a university/ HEI (higher education institution) as your primary employer.

If you were scheduled to be working for the HSC on a day of action, you may take industrial action, but you must not make arrangements to perform any private practice activity instead of your HSC work.

If you’re not taking industrial action

Some doctors may feel unable or unwilling to participate in the industrial action. We wholly respect their right not to participate but recognise that differences in opinion on this subject can be quite marked. Both doctors who are participating and those who are not should respect each other’s right to do so. There should be no coercion of colleagues to either take part or not.

However, even if you are not taking part in industrial action yourself, other colleagues will be and as such your service may not be able to function as normal. You must be aware that you might be putting patient safety at risk if you proceed with non-emergency and elective work.

Patient care

We know that SAS doctors may have concerns about patients in their particular specialty (e.g., oncology, paediatrics, etc.) and the impact that industrial action would have on them. That is why we provided employers with advanced informal notice about the dates we intend to take industrial action. We want to ensure Trusts and colleagues have had plenty of time to prioritise and reschedule the most urgent cases and minimise the impact on those patients.

Academics delivering HSC activity

If your primary employer is university/HEI, you will be expected to attend your NHS/HSC workplace as normal on any day on which you are job planned to be delivering NHS/HSC activity. 

However, services are likely to be significantly disrupted while other SAS colleagues are taking industrial action. Without access to other services, such as radiology and pathology, you will need to determine whether your service is able to function safely, or whether non-emergency and elective work can proceed.

We recommend that no elective activity should be scheduled for the strike days and that, where a Trust proceeds with such activity, a full risk assessment must be undertaken. Patients undergoing surgery or invasive procedures on an elective basis/not normally carried out on Christmas Day must be informed that the strikes are occurring, that there is additional risk in the event of complications, and their consent to proceed must be given.

Academics delivering academic work

If you are a clinical academic due to be delivering academic work for your university/HEI employer on the days of action, you should do that as normal.

Dealing with pressure to return to work