Preparing for industrial action

NHS trusts and NHS England continue to work with doctors and operational hospital staff to prepare for the latest planned events in the ongoing junior doctor industrial action. From 5-7 and 10-11 October 2016 we will see a full withdrawal of labour by junior doctors, which is unprecedented in the history of the NHS.  NHS England has written to all NHS Trusts asking organisations to provide additional Board level assurance and take extra steps to ensure ongoing patient care and safety:

Recently NHS trusts and NHS England have been working with doctors and operational hospital staff to prepare for the potential of junior doctor industrial action. As part of this process, NHS England has shared guidance for doctors and providers to ensure patient care and safety. The advice focuses on reducing demand in urgent and emergency care and practical steps to mitigate the loss of junior doctor capacity.

Junior doctors industrial action data collections

Data relating to the recent junior doctors industrial action was collected from all NHS trusts via the Unify data collection tool.  The following spreadsheets contain that data:

Staffing spreadsheet

On the days of action trusts were asked to complete staffing grids containing the numbers of doctors at work.  This data was collected by specialty and by grade, and was collected in respect of the position at 09.00 in the morning and 20.00 in the evening on days of action that covered elective care only, and at 09.00 in the morning only for the full strike on 26/27 April as the action finished at 17.00 on those days.  The breakdown by grade was as follows:

  • Foundation Doctor – Year 1
  • Foundation Doctor – Year 2
  • Specialty Registrar
  • Specialty, associate specialist and staff grade doctors
  • Consultant

The figures for the number of doctors at work during the action was then compared to a figures for a baseline time period or figures for expected numbers of doctors that would have been working if no action had been planned.  Dividing the actual numbers of doctors working by the expected/baseline figures  allowed us to calculate the percentage of doctors at work (using totals across all 5 grade breakdowns), and percentages of junior doctors at work (using the sum of the first 3 grade breakdowns above).  Note that the specific baseline/expected figures used for each of the periods of action are shown in the summary table in the staffing spreadsheet.

Cancellations spreadsheet

Trusts were asked to provide the number of elective procedures that they expected to cancel as a result of industrial action, in the days in the run up to the strike days and the days immediately after the strike.  In addition, for the action on 26/27 April they were also asked to prove figures for the expected number of cancelled outpatient appointments, split into the following categories:

  • New (first) outpatient (excluding 2 week wait) cancellations
  • New (first) 2 week wait outpatient cancellations
  • Review (subsequent) outpatient cancellations

Regional staffing spreadsheet

In addition to the data collected via Unify a further collection was carried out via regions, after the action on 6/7 April.  Trusts were asked to provide (split between emergency and elective cover):

  • Total number of junior doctors scheduled to work
  • Total number of junior doctors attended
  • Number of junior doctors that did not attend due to reasons other than strike action e.g. sickness
  • Total number of junior doctors scheduled to work
  • Total number of junior doctors attended
  • Number of junior doctors that did not attend due to reasons other than strike action e.g. sickness