Hospital leaders have expressed serious concerns about how they will be able to maintain patient safety during next week’s junior doctors’ strike.
Training doctors in England will stage their longest walkout between April 11 and 15.
NHS Providers, which represents NHS trusts, said the timing of the strike and its duration present a “range of challenges over and above the disruption seen from the industrial action in recent months”.
It said that during the strike, the NHS will focus resources on emergency treatment, critical care, maternity, neonatal care and trauma.
But even in these areas, there are “real concerns of a raised risk to safety”, it said.
The 96-hour strike is likely to be the most disruptive in the history of the NHS due to the length of the strike and the fact that doctors have chosen to take action directly after a long Bank Holiday weekend – which traditionally causes disruption to the NHS even without the prospect of strike action.
The walkout also coincides with the Easter school holidays, which means that many consultant staff who provided cover during the first round of strikes will be unable to do so again due to pre-planned holidays and childcare commitments.
The strikes could also lead to delays for some patients starting treatment – for instance, if a new cancer patient needed to start weekly rounds of chemotherapy, the start of their treatment may be delayed until after the strike action to ensure continuity.
Last month’s 72-hour walk out led to about 175,000 hospital appointments and operations being postponed.
Hospital leaders have raised concerns with NHS Providers about the impact of the strike.
I am not confident this time that we can maintain patient safety as we will not be able to provide the cover— Hospital trust chief executive
One hospital trust chief executive said: “This is less about what planned routine work gets pulled down and everything about maintenance of safety in emergency departments, acute medicine and surgery.
“Concerned doesn’t begin to describe it”.
Another said: “I am not confident this time that we can maintain patient safety as we will not be able to provide the cover.”
A third said: “Many of the consultants who stepped up to do nights last time are not available or are more reluctant this time.”
Another added: “Those with families almost certainly won’t as [they] can’t rearrange out of school holidays.”
Sir Julian Hartley, chief executive of NHS Providers, said: “It’s clear from our extensive dialogue with trust leaders that we are in uncharted territory.
“Yet again we are seeing colleagues pull out all the stops to minimise disruption and ensure patient safety.
“But the challenges here are unprecedented.
“It’s particularly important during the strike that in the event of an emergency the public continue to turn to the NHS. No effort will be spared to provide the care they need.
“But for less urgent cases, people should look first to 111 online if they can, to access appropriate treatment and advice.
“Even now it’s not too late for the two sides in this dispute, the Government and the unions, to recognise the gravity of the situation and step back from the brink.
“We need a solution to prevent further strikes, and we need it now.”
Dr Latifa Patel, workforce lead for the British Medical Association, said: “No-one understands better than us, the doctors who care for them, that patients are getting a substandard experience 365 days a year from an overstretched and understaffed NHS.
“In this brutal work environment, patient care is at risk every day due to chronic staff shortages and years of underinvestment in equipment and services.
“Given that as a starting point, during the previous strike days, NHS England and (hospital) trusts in England worked together to assess hospitals’ readiness for the planned industrial action.
“We have a jointly agreed system with NHS England in place to ensure patient safety in the event of extreme and unforeseen circumstances.
“We met with NHS England four times per day during the last strikes to monitor the situation, but there were no requests for a derogation – a temporary stoppage of the industrial action – to be made. The same proven arrangements will be in place this time.
“Junior doctors have no desire to strike, they been pushed into this action by long-term Government inaction and now want to bring this dispute to an end as quickly as possible.
“We hope the Health Secretary will come to the table immediately with a meaningful pay offer so doctors can avoid more strike action and instead return to doing what they want to be doing: caring for their patients.”
A Department of Health and Social Care spokesperson said: “Four days of strikes by junior doctors will risk patient safety and cause further disruption and postponed treatment.
“The BMA’s demand for a 35% pay rise is totally unreasonable and unaffordable.
“We urge them to come to the table with a realistic approach so we can find a way forward, as we have done with other health unions, which balances fairly rewarding junior doctors for their hard work with meeting the Prime Minister’s ambition to halve inflation.
“We are working with NHS England to put in place contingency plans to protect patient safety.
“The NHS will prioritise resources to protect emergency treatment, critical care, maternity and neonatal care, and trauma.”
