Junior doctors’ strike to affect patient care, NHS boss warns

Junior doctors’ strikes will have an “inevitable” impact on patient care, the head of the NHS in England has warned.

Amanda Pritchard said that the walkouts announced this week were at the top of the health service’s “worry list”.

It comes as NHS Providers, which represents NHS trusts, estimated that strikes have cost the health service in England £2 billion in “lost income”.

Speaking at the NHS England board meeting, Ms Pritchard described the strike announcement as “disappointing” and said that the service had made headway on the record waiting list during the brief respite from strikes while talks between unions and the Government were ongoing.

Cutting the waiting list is one of Prime Minister Rishi Sunak’s top priorities.

So far this year, hospital doctors have been on strike for almost 800 hours, “almost a 10th of a full year”, she said.

Ms Pritchard said that the strikes come at a “very challenging time” of year for the health service.

Winter is usually the busiest period for the health service as it grapples with a rise in seasonal viruses.

The NHS England chief executive described last winter as the “worst” in her health service career.

But she said the “immediate focus” is to prioritise patient safety during the walkouts.

“Industrial action announced this week by the BMA is top of everyone’s minds and worry lists.

“Both here as a board but right across the NHS,” she said.

”Since the board last met there have been no strikes, as ministers and the trade unions have been in discussions about reaching a pay settlement.

“It is worth noting that since the last set of strikes, we have seen improvement every single week in reducing long waits for patients.

“It is very positive that the Government announced that they and the unions representing consultant doctors in England have reached a position whereby the unions are able to put an offer to members following constructive negotiations.

“However, junior doctors have this week announced new rounds of action.

“This news is obviously incredibly disappointing for everyone involved.

”Particularly as it comes at an already very challenging time for the NHS, we have escalating winter pressures already with flu, Covid and norovirus – for norovirus in particular, we are at a worse point than we were last year.

“That’s on top of huge demand across the board.

“Over previous periods of industrial action we have seen not just a significant impact on patients waiting for elective care but also increased risk to patients who need time critical care too.

”We must not forget that behind every postponed appointment or procedure is a patient experiencing added distress, anxiety, and pain.

“This will be further heightened at this incredibly busy time of year.

”As we’ve discussed before, pay is a matter for Government and this dispute is between ministers and the trade unions.

“And NHS England’s role continues to focus on doing everything we possibly can to keep patients as safe as possible and minimise disruption where we can.

“And so, we will be working with the wider NHS and engaging with unions to do that.”

Ms Pritchard added: “If these strikes go ahead, overall, we will have seen a full year of strike action.

“And if just December strikes definitely go ahead, 2023 will end with almost 800 hours of industrial action by hospital doctors in total (792) – and if you think about that roughly – that’s 9% so almost a 10th of a full year.

”NHS England’s position remains that we respect the right of staff to take industrial action and the decisions of those who choose not to.

“We value our staff and understand that good pay and conditions are important, not only for individuals and their families but for wider issues such as retention and recruitment which impact on patient care, too.

”But while many people are preparing for Christmas celebrations, here in the NHS, we have a huge job ahead preparing for strikes.”

She added: “Our immediate focus is to support the NHS to plan to respond to the action and to discuss with the BMA how to best reduce the risk of harm to patients.

“Over the coming weeks, we will be making clear to our patients and the public that they must continue to come forward when they need urgent care.

“We will make sure we take time to thank staff who will be covering for their colleagues, to provide the best patient care they can.

“We absolutely cannot have a winter like last year, the worst of my own career, and clearly strikes will make this even harder.

“So, I don’t think anyone here at NHS England would disagree that we want to see a resolution to the dispute as soon as possible to prevent any further impact on patient care which, let’s be clear, is an inevitable consequence of strike action.

“So we would urge all sides to get back around the table to continue negotiations.”

The British Medical Association (BMA) announced strikes in England later this month and in January after talks with the Government to resolve the pay dispute broke down.

The three-day walkout in December, in just two weeks’ time, comes just days ahead of Christmas, while the six-day January strike will be the longest in NHS history.

Health commentators expressed dismay at the news, with many raising concerns for patient safety.

The BMA said on Tuesday that junior doctors have been offered a 3% rise on top of the average 8.8% increase they were given in the summer.

But the union said the cash would be split unevenly across different doctor grades and would “still amount to pay cuts for many doctors”.

On Tuesday, Health Secretary Victoria Atkins said the Government would “immediately look to come back to the table” if the junior doctors’ strikes were called off.

She warned that the walkouts will put extra pressure on the NHS during the busy winter period and “risk patient safety”.

Consultant doctors from the BMA have reached a deal with the Government which will see consultants earn more money from January 2024, although it will not be paid until April 2024.

England’s top hospital doctors are now voting on the deal, which would see them get a pay rise of between 6% and 19.6%.

Talks with specialist, associate specialist and specialty doctors (SAS) in England are continuing.

NHS Providers chief executive Sir Julian Hartley said: “A year of strikes has had a huge financial impact on the NHS, with around £2 billion in lost income from delayed operations, scans and procedures and the direct costs of providing cover for striking staff.

“At a time when NHS budgets are under serious strain, this is a cost the health service can ill afford.

“On top of this, spiralling medicine and energy costs have landed the NHS with an additional £1.7 billion bill due to inflation.

“Patients have been left paying the price, too. More than one million appointments have had to be delayed due to almost a year of industrial action.

“With more walkouts looming, it’s vital the Government and unions get back around the table and do everything they can to resolve these strikes.”

BMA junior doctors committee co-chairs Dr Rob Laurenson and Dr Vivek Trivedi said: “Our dispute started 14 months ago and before this last round of talks, the Government hadn’t formally engaged with us for almost six months. During these delays we were forced out on strike and patients’ care was needlessly disrupted.

“We are ready, as ever, to work towards bringing this dispute to an end but when we reached our mutually agreed deadline, and the pay offer on the table would have seen a large cohort of doctors still receive a pay cut this year, it was clear we hadn’t made enough progress.

“Overall we welcomed the constructive approach from these most recent talks and would very much like them to continue in an attempt to avert this industrial action, but it is the Government’s precondition not to talk while strikes are scheduled which is preventing this from happening.

“The Government can still avoid the need for these strikes: we will be ready and willing any time they want to talk. If a credible offer can be presented the day before, or even during any action, these strikes can be cancelled.

“Every winter we raise the alarm about the NHS and every winter the Government fails to put the necessary investment into staff to prevent the crisis – now is the time to break the trend.”