Londoners were on Thursday warned of the “most severe disruption” of any NHS strike so far as consultants began a 48-hour walkout over pay.
Thousands of consultant doctors and hospital-based dentists in the British Medical Association (BMA) walked out from 7am, bringing routine care “to a virtual standstill”.
London NHS Trusts warned that the disruption was expected to be particularly severe as other clinical staff cannot cover for consultants, the most senior doctors in the NHS. The strike follows a five-day walkout by junior doctors in the BMA - the longest in NHS history.
Consultants will continue to work in A&E departments during the strike as part of arrangements to provide a “Christmas-day” level of service, but Trusts expect to cancel thousands of operations and appointments.
Barking, Havering and Redbridge NHS Trust said it’s A&E would be under “considerable strain” during the strike, with 872 outpatient appointments and 61 non-urgent surgeries rearranged across its hospitals and clinics.
In a statement, the Trust said industrial action had cost the Trust £1.3m, while cancelled surgeries had resulted in £1.2m in lost income.
Tracey Moore, Chief Operating Officer at Kingston Hospital in south west London, said: “Waiting times in our Emergency Department will be longer than usual during the days of strike action and we will be prioritising patients based on the urgency of their clinical need – if we feel you could be seen elsewhere, we may redirect you.”
Analysis by the Standard showed that more than 166,000 operations, procedures and appointments have been cancelled in London this year during four rounds of industrial action by junior doctors. The figure is significantly higher than any other region in the UK and does not include rescheduled activity due to the nursing strikes, which lasted for over six months.
Consultants, like junior doctors, are seeking a 35 per cent pay rise to correct a real terms fall in income since 2008. A further walkout will take place on August 24 and 25.
Health Secretary Steve Barclay on Thursday insisted that his offer of a 6 per cent pay rise to junior doctors and consultant was “final”, adding: “My door is always open to discuss non-pay issues, but this pay award is final so I urge the BMA to end their strikes immediately.”
But the BMA has branded the offer “derisory” and urged Mr Barclay to reopen talks to avert further strikes.
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Sir Julian Hartley, chief executive of NHS Providers, which represents health trusts, said the impact on patients was likely to be “the biggest yet”.
“Eight consecutive months of industrial action is significantly hampering trusts’ efforts to meet vital targets including reducing the waiting list for planned care – now at a record high of 7.47 million.
“The strikes are also eroding staff morale as well as local employment relations between trusts, hospitals and their staff.”
According to the BMA, consultants on a 2003 contract earn a starting salary of £88,364 in basic pay, rising to £119,133 after around 19 years. The union claims that doctors’ pay has fallen way behind the likes of lawyers, architects and financial advisers.
The Department of Health said extra payments such as clinical excellence awards and cash for being on call would take the average NHS pay for consultants in 2023/24 to around £134,000.
A letter sent to hospital chiefs by the BMA and NHS England earlier this month said care will be provided where there is a risk of serious harm (often called life and limb cover) caused by delaying or deferring procedures due to the strike action.
This care may include urgent or time-critical services such as urgent palliative and end-of-life care, dialysis, urgent maternity care, mental health crisis care and critical cancer care, it said.
The letter added that consultant strikes are “different to previous rounds of industrial action” because “no other worker can provide cover for consultants, and other staff groups are dependent upon supervision from consultants to be able to work. Almost no activity in a hospital can occur unless it is listed under and supervised by a named consultant.”
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During the 48-hour strike, the public is being urged to dial 999 for life-threatening emergencies and to contact NHS 111 online for other health concerns.
GP services and pharmacies will be running as normal.
Doctors are joining picket lines across England while a rally will be held at the BMA headquarters in central London on Thursday afternoon, attended by its consultants’ committee chair Dr Vishal Sharma.
Dr Sharma said: “This dispute is not just about one year’s pay settlement, it is about the reality of 14 years of consultant pay falling behind, about our a loss in our pay in real terms of 35 per cent and the broken pay review system that has allowed this to happen.
“Last week, the Prime Minister described the pay review body’s 6 p[er cent pay uplift as a ‘significant pay award, one of the most significant we’ve had in decades’ and yet our profession languishes so far behind tens of thousands of other workers in terms of our pay and working conditions.
“Consultants will stand on the picket lines today because we are angry and at rock bottom. We never wanted to be forced into taking this huge step.”
Mr Barclay said he hugely valued the work of NHS consultants and had accepted independent pay review body recommendations in full to give the medics a 6 per cent pay rise this year, on top of last year’s 4.5% increase.
He added: “This Government has also reformed pension tax rules for consultants, something the BMA campaigned for over many years.
“I am disappointed the BMA is going ahead with this week’s strike, given the average consultant’s NHS earnings are expected to increase to £134,000 a year.
“My door is always open to discuss non-pay issues, but this pay award is final so I urge the BMA to end their strikes immediately.”