Classification: Official
Publication reference:  PRN00677

To:

• ICBs:
  • chief executives NHS England Wellington House
  • chief operating officers 133-155 Waterloo Road
  • chairs London
  • chief people officers/HR directors SE1 8UG
• Trusts:
  • chief executives 01 August 2023
  • chief operating officers
  • chief people officers/HR directors
• CSU managing directors

cc.

• Regional:
  • directors
  • directors of nursing
  • heads of EPRR

Dear Colleagues,

Industrial action – BMA and HSCA Junior doctors and BDA dental trainees (11 – 15 August 2023); BMA and BDA Consultants (24 – 26 August 2023): Pre-action self-assessment, rescheduled activity, and workforce data collections

This letter provides information regarding NHS England’s approach to pre-action self-assessment and reporting of workforce and rescheduled activity impacts of the industrial action announced by the British Medical Association (BMA) and Hospital Consultants and Specialists Association (HCSA) junior doctors and British Dental Association (BDA) dental trainees from 7:00 am on Friday 11 August – 7:00 am Tuesday 15 August. It also sets out the approach for action by consultant members of the BMA and BDA consultants from 7:00 am on Thursday 24 August – 7:00 am  Saturday 26 August 2023.

Based on their experience of previous action by both Consultants and Junior Doctors, we are asking Trusts to optimise the volume of planned and elective activity, planning for the entirety of the cumulative period of disruption (both strikes and days in between and either side) and the upcoming bank holiday (Monday 28 August).  Where appropriate, urgent elective surgery (P1 and P2), cancer care (particularly for patients who have already been waiting over 62 days, or who are likely to pass day 62 if their appointment needs to be rescheduled), and long waiters should be the final cohorts to be rescheduled. 

As with July’s industrial action by Consultants, complex planning will be required across different services within each Trust (for example surgical and ITU teams) to ensure adequate staffing through the entirety of urgent care pathways and other services.

Early and systematic discussion between specialties and service areas is key to ensure a shared understanding of expected staffing levels – as is dialogue between staff, management, and the local negotiating committee.

Use of temporary staff

NHS systems and trusts should review their use of temporary staff during this period to take account of the High Court ruling that found that the Government’s decision to introduce regulations which permitted the use of temporary staff to replace striking workers was unlawful.  This ruling takes effect from 10 August and will apply to this set of Industrial Action. Organisations should take account of legal update and advice issued by NHS Employers and/or their own legal advice in their planning for forthcoming strikes.

An additional question has been included in the ICB pre-action self-assurance templates for both Junior Doctor and Consultants industrial action to capture the impact of this judgement.

Pre-action self-assessment – ICB requirement

Ahead of industrial action, NHS England is requesting ICBs to report confidence in their service provision in their area. There are two excel self-assessment templates provided with this letter, one for each of the upcoming actions. They set out questions to capture the likely impact of action by HSCA and BMA junior doctors, and BDA dental trainees from 11-15 August and BMA and BDA Consultants from 24-26 August 2023.

In line with the NHS operating model and ICBs’ responsibilities as Category 1 responders and system leaders, we are asking for returns to be completed by ICBs only.

Our expectation is that returns are co-ordinated by ICB EPRR leads informed by decision-making and operational planning led by Medical Directors and Workforce/People directors.  

The self-assessment return should be informed by dialogue with Trusts, understanding of plans at Trust and place levels, as well as ICB- and network-level preparations.

We will use your information to identify risk areas for escalation or further guidance, to guide our conversations with Trade Unions and the Government, and to focus our support for systems.

Pre-action self-assessment – deadlines and assumptions

For junior doctors’ industrial action, ICBs are asked to complete the template on the basis that no derogations are agreed (beyond the stated commitments to recall staff in the event of mass casualty incidents).

ICBs first template return (due with the NOC by 10:00 am on Tuesday 8 August) should provide an initial assessment of readiness for junior doctors’ industrial action. We appreciate that detail will improve as planning progresses and that initial assessments will be updated.

The second return (due with the NOC by 10:00 am on Thursday 10 August) should confirm each ICB’s readiness position ahead of junior doctor action.

ICBs will be informed of the regional submission date and time by their NHS England regional office. This will be in advance of the deadlines stated above. This timing will be aligned to ensure the region has time for review returns ahead of submission to the National Operations Centre (NOC).

For BMA and BDA consultant action, ICBs are asked to plan and complete the template based on local intelligence on staff intent and reflecting your area’s ability to ensure minimum sufficient consultant cover to manage anticipated demand, based on Trusts’ assessment of likely staffing levels on the day and progress of discussions with Trade Unions and staff.

We will reissue the guidance on the BMA derogation process for both junior doctors and consultants along with the associated form and any necessary updates once it has been reconfirmed by the BMA.

At present it is anticipated that the same process will apply, including a commitment to recall of staff in the event of externally declared major incidents with mass casualties, and a process for advance agreement of derogations (in exceptional circumstances only).

A written return from ICBs setting out readiness in relation to the action being taking by Consultants will be expected by Wednesday 23 August (due with the NOC by 1000).

ICBs will be informed of the regional submission date and time by their NHS England regional office. This will be in advance of the deadline stated above.

Pre-action self-assessment – Regional role

Regional Operations Centres are asked to liaise with ICBs to ensure a comprehensive and accurate picture of local preparations and to identify service and geographical areas of concern. Where ICBs indicate there are trusts or services of concern and the return does not provide detailed information, NHS England region should contact the relevant ICB for further detail.

Once regions have collated and reviewed each set of ICB returns, regional EPRR teams are asked to complete a regional overview template, and to send both this regional overview and the collated ICB returns for their region to the NOC.

When the second return for JD’s (due with the NOC by 10:00 am on Thursday 10 August).  We will also at this stage ask for regions for early indications of any areas of concern ahead of consultant action.

Regions are also asked to ensure they are able to give a verbal ICB by ICB level outline of key concerns and risks relating to consultants IA at the IA working group meeting on Monday 21 August. 

Workforce and rescheduled activity situation report (SitRep) data collections

NHS England will conduct two SitRep data collections via the Strategic Data Collection Service (SDCS):

1. Industrial Action workforce SitRep. This will collect numbers of staff taking part in the industrial action, and total numbers of staff due to be at work. The collection will be open for all ICBs and Trusts. All organisations are requested to submit data, even if it is a nil return. The template for this can be found in Annex A.
2. Industrial Action rescheduled activity SitRep. This will collect information on activity that has been rescheduled because of the industrial action. The collection will be open for all acute, community and mental health trusts and will request the figures of rescheduled activity. All organisations are requested to submit data, even if it is a nil return. The template for this can be found in Annex B. Guidance for completion is provided as Annex D.

SitRep data collections – dates, timing, and guidance

The rescheduled activity collection will run three times for each action;

• For Junior Doctors industrial action – on Monday 7 August and Thursday 10 August (to provide an initial internal estimates and aid in planning), and Tuesday 15 August (to provide final figures for the impacts of the industrial action by junior doctors). For the initial Junior Doctor Industrial Action this will be a nine-day period of 09 – 17 August inclusive.
• For Consultants industrial action – on Friday 18 August and Wednesday 23 August (to provide an initial internal estimates and aid in planning), Tuesday 29 August (to provide final figures for the impacts of the industrial action by consultants). This collection takes place on the first working day following action. For the Consultant action it will cover a nine-day period 22 – 30 August inclusive.

Collections prior to the periods of industrial action will be used to understand the anticipated position of each Trust and help NHS England target regional support and follow-up – data will not be published.

Highlights of the data collected on 15 and 29 August following each period of industrial action will be published on NHS England’s website in the usual way.

The workforce collection will run twice:

• For Junior Doctors industrial action – on Tuesday 15 August (to cover junior doctors’ industrial action from 11 – 15 August)
• For Consultants industrial action – on Tuesday 29 August (to cover consultants’ industrial action from 24 – 26 August).

This data is published and used for both internal and media reporting therefore it is important that an accurate submission is received from every organisation. The window will close at 13:00 on the days of collection and will not be reopened.

Submissions will be made through the SDCS platform. On any day that the collection is running we will open the collection at 09:00 and the deadline for submission will be 13:00 that day. The template will be available to download from SDCS from 09:00 on the first day the collection is running. Missing returns will be highlighted to regional Chief Operating Officers for follow-up.

A schedule highlighting which data will be collected on each date is included at Annex C.

More detailed guidance notes will be shared with those registered as submitters in SDCS ahead of the first collection. An extract can be found in Annex D.  If you have any questions, please contact your regional team.

Updates on the days of strike action

Use of any additional template or SitRep returns ‘on the day’ are for NHS England regional team and ICB agreement, during the planning stage.

Many thanks for your continued cooperation and support in providing this information and ensuring a high return rate. And thank you for your continued efforts to provide NHS patients with the best possible care during these challenging periods of Industrial Action.

Yours sincerely,

Mike Prentice, National Director for Emergency Planning and Incident Response, NHS England.

Annex A – Workforce collection

Collection on 15 August

Collection on 29 August

Annex B – Rescheduled activity SitRep

Collection on 7, 10, 15 August

Collections on 18, 23, 29 August

Annex C – Schedule of data collections and pre-action self-assessment returns

Annex D – Extract from guidance for Industrial Action Sitrep collections – July 2023

Rescheduled activity SitRep