NHS briefing: Industrial action winter 2023
Potential NHS strikes
A number of NHS trade unions in England have balloted their NHS members to take part in industrial action. As a result, strike days have been announced for a number of services.
What the NHS is doing
The role of the NHS during any industrial action is to ensure that patients are kept as safe as possible and that services are maintained as effectively as possible.
NHS organisations with capacity will aid those who require extra help.
NHS organisations are in regular and open discussions with trade unions to secure derogations so lifesaving services can continue.
With the government, the NHS will work with the armed forces to ensure ambulance services are supported.
The NHS is in discussions with the independent sector, voluntary sector and social care on how they provide extra support.
NHS England has issued affected organisations with a self-assessment checklist to support their preparations. NHS England is assessing affected organisations and offering planning support where needed.Supporting trust planning
NHS England creates a national planning framework and has set out a checklist of preparations for trusts in advance of strikes, offering additional support where needed.
Detailed preparations are made at a local, individual trust level with NHS England regional teams supporting trusts in their planning and identifying where mutual aid between trusts can be provided.
Agreeing strike derogations to protect services and patient safety
NHS England has also held discussions nationally with unions on what services will continue – services that are ‘derogated’ from industrial action – across the country. As a result of these talks, the Royal College of Nursing (RCN) has agreed that chemotherapy, dialysis, critical care units (such as intensive care and high dependency), neonatal, paediatric intensive care and paediatric A&Es will be exempt from strike action.
These conversations are continuing nationally with the RCN and the unions representing ambulance staff. Talks are also happening locally between NHS trusts and strike committees to agree what needs to happen to keep patients safe. Until discussions with the unions have concluded and we know actual staffing levels on the days in question, it is impossible to predict the full extent of the impact of any strike action. This will inevitably vary from place to place.
Managing risk
Trusts, supported by NHS England, will do all they can to manage the disruption of any industrial action. Trusts will concentrate on ensuring the safe provision of urgent and emergency care, particularly for life threatening illnesses, triaging as needed on the basis of clinical priority. Trust leaders will do all they can to preserve planned care, but strike action will inevitably mean some disruption.
Each ambulance trust will draw up a detailed plan for each strike day. Mitigations for the ambulance strike days being considered include:
- using the military to transfer patients with less urgent conditions to and from hospital
- using St John Ambulance and Community First responders
- using taxis to transport less critically ill people to and from hospital where clinically appropriate
- ensuring strong clinical triage in call centres
- optimising discharges from hospitals to create capacity.
Messages for the public
Nobody should put off seeking emergency care. Key life-saving services are set to continue.
Patients whose conditions are not life-threatening are likely to experience delays in accessing urgent care in affected trusts and during ambulance strikes.
Patients should attend as normal during strike days. Some planned care appointments may be rescheduled. Hospitals will contact patients directly if their appointments need to be rescheduled due to industrial action.
As always, anyone who needs less urgent care can also use NHS 111 online for advice.
Primary care is not affected by the current planned strikes, so people should continue to attend their GP or dental appointments.
Key questions and answers
Anyone who needs urgent care should use NHS111 online or call NHS 111 to be assessed and directed to the right care for them. When someone is seriously ill or injured and their life is at risk, you should seek emergency care in the normal way, by calling 999 or attending A&E.
Not every hospital and ambulance service will be affected by strike action. You can check which trusts are affected on each trade union’s website:
- Royal College of Nursing(18 and 19 January 2023)
- UNISON(11 and 23 January)
- GMB(11 January)
Everyone who has an appointment should attend as planned, unless your local NHS provider has contacted you to reschedule. If we have not contacted you, please attend your appointment even if your Trust is affected by strikes.
Emergency care will continue to be available across all parts of the country. It is really important that in emergency and life-threatening cases – when someone is seriously ill or their life is at risk patients continue to come forward as normal.
All hospital inpatients will be informed of how their care will be impacted on a ward-by-ward basis by the staff involved in delivering their care.
GP services will be running as normal on strike days. Please continue to attend scheduled GP appointments.
The NHS will contact you if your appointment needs to be rescheduled due to strike action. This is likely to be a text, phone call or a letter, and you should be offered an alternative date for your appointment. If we have not contacted you, please attend your appointment as planned.
Any appointments that need to be rescheduled will be done so as a priority.
No, the NHS will contact you if your appointment needs to be rescheduled due to strike action.
No, if we have not contacted you, please attend your appointment as planned.
On strike days, patients should only call 999 if seriously ill or injured, and there is risk to life. Ambulances will be dispatched where clinically appropriate.
For all other health care needs support will be available through NHS 111 online, via the NHS 111 helpline or at your local GP or pharmacy.
The NHS.UK website has more information on when to call 999 and when to go to A&E.
Patients should only call 999 if seriously ill or injured, and there is risk to life. Ambulances will be dispatched where clinically appropriate.
The nurses strikes on 18 and 19 January 2023 will last for 12 hours and the ambulance strikes on 23 January 2023 will last for up to 24 hours (this will vary across different ambulance services). However patients should be aware that it may take slightly longer for services to return to normal.