Hospital bosses are worried about keeping patients safe overnight this week because of a shortage of consultants available to cover for striking junior doctors.
When junior doctors in England staged their first strike in mid-March in their pay dispute with the government, their consultant colleagues covered for them for the three days involved.
However, fewer consultants are available to do the same during this week’s four-day stoppage because it coincides with Easter, Passover and Ramadan and many are off.
NHS Providers, which represents health service trusts, highlighted the difficulty hospital bosses are facing in trying to ensure nightshift medical rotas are fully staffed this week. They aired their concern on the first day of strike action that will severely disrupt NHS services until it ends at 7am on Saturday and, bosses have warned, for many days afterwards.
“Getting through today is just the start. Trust leaders are worried about securing adequate cover for the night shifts ahead. This is going to be a very long, difficult week for the NHS,” said Miriam Deakin, the head of policy at NHS Providers. “Keeping patients as safe as possible, trusts’ No 1 priority, will be even harder than in previous strikes so it’s all hands on deck.”
Other health professionals, including GPs, paramedics and pharmacists, were helping hospitals ensure patients received good care, Deakin added.
One trust chief executive said: “I feel the same as do my MDs [medical directors]. Many of the consultants who stepped up to do nights last time are not available. The cumulative impact of 10 days of reduced service is extremely worrying from a safety perspective.”
Matthew Taylor, the chief executive of the NHS Confederation, on Monday said the NHS in England was facing “a perfect storm” this week because of the timing of the junior doctors’ action. When asked whether the 96-hour stoppage would be worse than a 72-hour strike by NHS staff last month, Taylor told BBC Breakfast: “It will be worse, there’s no question.
“Not only is the action longer, it’s four days, but it’s sandwiched between the Easter bank holiday weekend and another weekend, and it’s a time when many consultants will have booked holiday, we have Ramadan, we have Passover as well. In a sense it’s a perfect storm, in terms of the capacity of the health service.”
Many consultants are happy to deputise for and “act down” to cover their junior colleagues’ shifts this week.
I fully support the junior doctors strike. Strike hard - all the Vascular consultants at the Freeman Hospital have got your back. We believe you deserve full pay restoration. @SteveBarclay get yourself to a negotiation table with the @TheBMA #juniordoctorstrikes #PayRestoration
— Rachel Bell (@rebellvascular) April 11, 2023
However, others are frustrated that staging the strike during the Easter school holidays, when many consultants have booked to take leave, is making it harder to ensure full cover.
A senior hospital specialist said: “Most consultants I know are still very supportive of the cause juniors are fighting for and still up for covering their shifts during the strike. However, the very short notice of the strike, and deliberate choice of Easter school holidays after a four-day [bank holiday] weekend, will make things more inconvenient and disruptive, which I realise is the idea.”
NHS chiefs have estimated that hospitals are having to cancel between 250,000 and 350,000 outpatient appointments and operations that were due to take place this week.
Hospital bosses who spoke to the Health Service Journal also voiced unease about how a lack of consultant cover could affect the quality and safety of patient care this week.
One said that a quarter of the consultants in their trust, in the east of England, were on leave because of Easter. “We have all areas covered but they are very fragile. If a couple of key posts go sick, we’re in trouble. I’m much more concerned about clinical safety than at any time during the Covid surges,” they said.
A senior figure at another trust also aired their worry that with so few consultants available this week, sickness could mean that planned rotas for services such as neonatal care “will be broke” if one or two of those due to be on duty fall ill.
The British Medical Association (BMA) and the health secretary, Steve Barclay, remain deadlocked over the union’s demand for a 35% pay rise for junior doctors. Downing Street on Tuesday defended its position of refusing to talk to the BMA unless the union abandoned its call for the 35% rise and called off the strikes.
Rishi Sunak’s spokesperson said he would be kept up to date about the impact of the industrial action from Downing Street and Belfast, where he was travelling for the 25th anniversary of the Good Friday agreement.
“We call on the BMA junior doctors to cease their strikes and revise their starting point for negotiations, which is 35%,” the spokesperson said.
They said the pay rise demand was unreasonable and unaffordable for taxpayers, calling it “completely out of step with pay settlements in other parts of the public sector” and claimed it would cost £2bn.
However, the BMA has made clear since last week that it is prepared to negotiate on the 35% figure. It has called on Barclay to make “a credible offer” that would get talks started and enable them to call off the strikes.
