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Row over emergency cover for striking doctors amid patient safety fears

More than 20 hospitals plead for striking junior doctors to return to work amid patient safety fears - but the BMA rejected most requests

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Junior doctors who are members of the British Medical Association (BMA) outside Royal Victoria Infirmary, Newcastle, as they take to picket lines in a six-day walkout (Photo: Owen Humphreys/PA)
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The Prime Minister has backed NHS leaders after more than 20 hospitals pleaded for junior doctors to leave picket lines and return to work amid patient safety fears.

The hospitals had requested striking doctors return to work over safety concerns on the first day of a six-day walkout. But most of the requests were rejected by the British Medical Association (BMA), which claims hospital bosses are not exhausting all other avenues before issuing them.

Around 175,000 appointments and operations are expected to be cancelled as a result of the 144-hour strike. Trusts have said they are prioritising emergency and urgent care units and have drafted in staff from other areas to cope with what is traditionally the busiest time of the year for the NHS.

Several hospitals have already said they are facing “extreme pressure” since the longest strike in NHS history began on Wednesday morning and at least two have declared critical incidents and called neighbouring trusts for help.

Rishi Sunak said NHS chief executives had his “backing”, telling broadcasters in Nottinghamshire: “The NHS is responsible for patient care and it’s right that they do absolutely everything they can to ensure patient care. These strikes are disrupting people’s lives. They are causing an enormous amount of concern to people.

“It’s absolutely right that NHS leaders, completely independent of government, are making clinical decisions on the ground. And requesting that extra support where they feel that they need it. Of course they have my backing in doing that.”

The BMA criticised NHS officials for not submitting the requests properly and putting the union in an “impossible” situation.

As part of the agreed process, trusts are expected to show they have exhausted all other sources of staffing before recalling junior doctors back to work. This could be via the cancellation of planned, but not urgent, treatment and rearranging urgent cases to days around or outside strike action. They can also incentivise staff who are not taking strike action to work on strike days.

The BMA said although the process has worked well in all previous rounds of strike action, NHS England and some trusts who are requesting derogations, are now refusing to provide the union with evidence that they have undertaken these steps.

In a letter to Amanda Pritchard, NHS England chief executive, on Wednesday night, the chair of the BMA Council, Professor Philip Banfield, wrote: “This refusal to provide the information necessary to take well informed decisions is fundamentally undermining the derogation process as we are being asked to take decisions about our members’ right to strike without the requisite information. NHS England, it seems, is wilfully placing the BMA in an impossible situation.”

Professor Banfield accused NHS bosses of bowing to political pressure over the recall row, which he said undermines the strike action and will push the BMA into refusing an increasing number of requests.

Matthew Taylor, chief executive of the NHS Confederation, rejected the BMA’s claim that hospitals are misusing the system to recall striking medics.

He told LBC: “We see no evidence at all that any NHS trusts are calling junior doctors back in to work lightly.”

An NHS England spokeswoman said: “The NHS has a robust process in place for seeking derogations from the BMA to prioritise the safety of our patients and this has involved providing strong evidence where the most challenged systems need support.

“Nationally, we will continue to support local medical directors and other clinicians as they work hard to deliver the safest possible services for patients. Given this period of industrial action coincides with the most difficult time of year for the NHS, it is to be expected that more senior medical leaders will ask their colleagues for allowances to be made to ensure safe levels of cover.”

Services across England said they faced “significant demand” just hours after junior doctors embarked on a six-day walkout on Wednesday.

Hospitals in Portsmouth and Nottingham declared critical incidents as their wards and emergency departments were “full”. Other hospitals reported “extreme heightened pressure” and being “exceptionally busy”, with one citing a maximum A&E waiting time of more than 16 hours.

Mr Taylor said the situation would be likely to worsen into the weekend. “NHS trusts have been working at pace to prepare for these strikes, which come during one of the busiest weeks of the year for the health service,” he said.

“They are dealing with rising levels of winter viruses in the midst of industrial action and higher than anticipated staff sickness. A number of trusts have already declared critical incidents, with pressure likely to get worse as the walkout continues this week.

“Rather than accusing hospital leaders of refusing to provide the required information in full to the BMA, this is more about them needing to limit the precious time they and their teams have available to filling in forms when patient safety could be at risk.”

Mr Sunak called on junior doctors to end their strike amid severe pressure on health services.

He said: “I come from an NHS family. So, I know how important this is. And why we’ve prioritised it since I became Prime Minister. Anyone who needs emergency treatment should just contact their health service as they normally would. But what it does highlight is the damage that these strikes are having.

“At this point, every other part of the NHS workforce has found a sensible, fair agreement with the Government including nurses, midwives, paramedics, consultant, doctors and specialty doctors. It’s only the junior doctors who are now on strike and I would urge them to get round the table so that we can resolve this, and bring an end to this disruption and the impact it is having on more people up and down the country.”

The BMA said junior doctors’ pay has been cut by more than a quarter since 2008. Last summer, the Government gave junior doctors in England an average rise of 8.8 per cent, but medics said the increase was not enough and ramped up strike efforts.

Late last year, the Government and junior doctors entered talks, but after five weeks, the negotiations broke down and more strikes were called.

Junior doctors from the Hospital Consultants and Specialists Association union will join colleagues on picket lines. Consultants and SAS [specialty and specialist grade] doctors have agreed on a deal with the Government, which is being put to BMA members.

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