Publication reference: PRN01156
To:
- ICBs:
- chief executives
- chief operating officers
- chairs
- chief people officers/HR directors
- medical directors
- directors of nursing
- heads of emergency preparedness
- Trusts:
- chief executives
- chief operating officers
- chief people officers/HR directors
- medical directors
- directors of nursing
cc:
- Regional:
- directors
- P&I directors
- medical directors
- directors of nursing
- heads of emergency preparedness, resilience and response (EPRR)
Dear Colleagues,
Pre-action self-assessment, rescheduled activity, and workforce data collections for industrial action by Junior Doctors in February 2024
This letter provides information regarding NHS England’s approach to pre-action self-assessment and reporting of workforce and rescheduled activity impacts ahead of upcoming industrial action by members of the British Medical Association (BMA) from 7.00am Saturday 24 February – 11.59pm Wednesday 28 February 2024 and members of the Hospital Consultants and Specialists Association (HCSA), from 7.00am Saturday 24 February – 7.00am Thursday 29 February 2024.
The BMA and HCSA have announced a full withdrawal of labour by their junior doctor members. Effective management of this situation will require clear communication between staff, management, and local negotiating committees, based on thorough clinical risk assessments.
Expectations for trust and integrated care board planning
Trusts and integrated care boards (ICBs) must strategically plan for the period of action, prioritising patients with urgent needs and those with deteriorating conditions. This includes ensuring adequate staffing for all urgent care pathways, elective surgeries, maternity services, and other critical areas.
This level of disruption to staffing will cause a significant reduction in elective activity. Urgent elective surgery (P1 and P2) including but not limited to trauma, cardiac, corneal transplant, and cancer care should be protected where possible. A particular focus should be on patients who have already been waiting over 62 days, or who are likely to pass day 62 if their appointment needs to be rescheduled). Long waiters should be the final cohorts to be rescheduled.
Proactive efforts should again be made to discharge patients who are ready and to manage bed occupancy effectively in advance of, and during, strike action. We encourage organising MADE-style events and fully leveraging community response, intermediate care, falls prevention, and Enhanced Health in Care Homes programmes. Collaboration with local authorities to facilitate discharges before and during the strike period is vital.
ICBs are expected to ensure primary and community services are prepared to offer extended support, focusing on enhanced discharges, and supporting as many patients as possible in community or home settings, utilising services like urgent community response.
Patient Safety Mitigations (PSMs)
NHS England will be discussing the process for PSM requests with the BMA and HCSA in the coming days, and further information on the process and criteria to be used for this period of industrial action will be shared when it becomes available.
Trusts and ICBs should not plan on the basis that PSM requests will be agreed.
Pre-action self-assessment – ICB requirement
As per previous returns, we are asking ICBs to complete a pre-action self-assessment using the template provided. This will help identify areas of risk and inform our strategies and support mechanisms.
Subject to conversations with Trade Unions we may require ICBs to provide additional information on specific services which will be separate from this request.
Pre-action self-assessment – deadlines
Initial feedback on readiness and risks will be conducted and collated through existing regional and national incident planning and management meetings, with a structured verbal assessment by regional and national teams on Wednesday 21 February 2024.
A written return will be required from each ICB, and this will be analysed by national teams and discussed with regional teams on Friday 23 February 2024.
Regional colleagues will be in touch with ICBs to confirm the exact date and timings for ICBs to submit their returns to their Regional Operations Centre (ROC).
Pre-action self-assessment – regional role
Regional Operations Centres (ROCs) are asked to work with their regional EPRR colleagues to ensure a comprehensive and accurate picture of local preparations and to identify service and geographical areas of concern, from all ICBs. Where ICBs indicate there are trusts or services of concern and the return does not provide detailed information, the ROC or other NHSE regional colleagues should contact the relevant ICB for further detail.
Situation report (SitRep) data collections
NHS England will conduct two data collections via the Strategic Data Collection Service (SDCS):
a. Industrial Action rescheduled activity. 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. The template for this can be found in Annex A. Guidance for completion is provided at Annex C.
b. Industrial Action workforce SitRep. Please provide the following information using the template which can be found in Annex B:
- the total number of doctors in training (headcount) taking part in the industrial action on the reported day (please do not include staff absent from work due to TOIL that they have accumulated as a consequence of working during previous strikes), and
- the total number of doctors in training (headcount) due to be at work on the reported day.
SitRep data collections – which organisations should complete the collections?
All NHS provider Trust organisations are requested to submit data, even if it is a nil return. ICBs (as an employer) are not required to submit a response to the Workforce collection.
We are aware that due to the nature of SDCS, some non-NHS organisations such as Community Interest Companies may receive requests to complete these Sitreps. Returns from CICs are optional.
SitRep data collections – when will collections run and what dates are in scope?
The rescheduled activity collection will run three times and cover the following periods;
|
Period of action Date |
D-3 (activity est.) Date |
D-1 (activity est.) Date |
D+1 (activity impacts and workforce) Date |
Period covered by the collection Dates # Days | |
| Sat 24 – Thurs 29 February 2024 |
Wed 21 February |
Fri 23 February |
Fri 1 March |
22 Feb – 4 Mar |
12 |
The workforce collection will run once following the period of industrial action on Friday 1 March.
Highlights of the activity and workforce data collected following industrial action will be published on NHS England’s website in the usual way.
Use of any additional template or SitRep returns ‘on the day’ are for NHSE regional team and ICB agreement, during the planning stage.
SitRep data collections – guidance for submitters
The window will close at 1.00pm 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 9.00am and the deadline for submission will be 1.00pm that day. The template will be available to download from SDCS from 9.00am on the first day the collection is running. Missing returns will be highlighted to regional Chief Operating Officers to follow-up.
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 C.
Thank you for your ongoing cooperation and assistance in providing this information and ensuring a high response rate. We appreciate your dedicated efforts to deliver the highest quality care to NHS patients during these challenging times of industrial action. Should you have any queries, please reach out to your regional team.
Yours sincerely,
Mike Prentice, National Director for NHS Resilience, NHS England.
Annex A – rescheduled activity SitRep
Collection period 22 February – 4 March 2024.
Annex B – workforce collection
Collection on Friday 1 March.
Annex C – extract from guidance for Industrial Action Sitrep collections
Rescheduled activity SitRep.
| Column name | Guidance |
|---|---|
|
Date |
Specify the day that the appointment was originally planned for |
|
1a. All Inpatient | A count of all standard inpatient (i.e. Not Day case) appointment/ procedure scheduled for the specified date that has been changed by the provider due to industrial action. This includes both appointments where a new date has been provided and those where a new date has not yet been confirmed. |
|
1b. of which P1/P2 cancer surgery |
Of all those in 1a, the number that were for P1/P2 surgeries relating to cancer a cancer pathway. |
|
1c. of which P3/P4 cancer surgery |
Of all those in 1a, the number that were for P3/P4 surgeries relating to a cancer pathway. |
|
1d. of which cancer colonoscopy |
Of all those in 1a, the number that were for colonoscopies relating to cancer a cancer pathway. |
|
1e. of which radiotherapy treatments |
Of all those in 1a, the number that were for radiotherapy. |
|
1f. of which chemotherapy treatments |
Of all those in 1a, the number that were for chemotherapy. |
|
2a. All Day case | Any Day Case inpatient appointment/ procedure scheduled for the specified date that has been changed by the provider due to industrial action. This includes both appointments where a new date has been provided and those where a new date has not yet been confirmed. |
|
2b. of which cancer surgery |
Of all those in 2a, the number that were for surgeries relating to cancer a cancer pathway. |
|
2c. of which cancer colonoscopy |
Of all those in 2a, the number that were for colonoscopies relating to cancer a cancer pathway. |
|
2d. of which radiotherapy |
Of all those in 2a, the number that were for radiotherapy. |
|
2e. of which chemotherapy |
Of all those in 2a, the number that were for chemotherapy. |
|
3a. Total Outpatient appointments | Count of all outpatient appointments/ procedures scheduled for the specified date that has been changed by the provider due to industrial action. This includes both appointments where a new date has been provided and those where a new date has not yet been confirmed. This cell is auto-calculated from the contents of 3b and 3c |
|
3b. All New (incl 2 week waits) | Of all those in 3a, how many rearranged appointments are New appointments, including those from a 2 week wait referral including triage appointments. |
|
3c. Reviews |
Of all those in 3a, how many rearranged appointments are review appointments. |
|
4a. Of 3a, the total Cancer-related outpatients | Count of all cancer related outpatient appointments/ procedures scheduled for the specified date that has been changed by the provider due to industrial action. This includes both appointments where a new date has been provided and those where a new date has not yet been confirmed. |
|
4b. New 2 week waits inc triage appointments |
Of all those in 4a, how many rearranged appointments are New, 2 week wait referral appointments, including triage appointments. |
|
4c. Of which are cancer colonoscopy |
Of all those in 4a, how many rearranged appointments are for a colonoscopy appointment relating to a cancer pathway. |
|
4d. Of which are radiotherapy |
Of all those in 4a, how many rearranged appointments are for a radiotherapy appointment. |
|
4e. Of which are chemotherapy |
Of all those in 4a, how many rearranged appointments are for a chemotherapy appointment. |
Full guidance will be shared with SDCS submitters ahead of collections.