‘Cumulative’ impact of doctor strikes are now causing ‘significant disruption and risk to patients’, NHS England has told the BMA in a formal warning letter.
However the BMA argued that patient safety is being put at risk due to strike planning failures by NHS England.
Following months of walkouts, consultants and junior doctors are jointly striking for three full days this week, with ‘Christmas Day’-level cover.
NHS England noted doctors are taking ‘lawful industrial action in line with their respective mandates’, added that it is ‘increasingly concerned that the cumulative impact of this action is causing significant disruption and risk to patients’.
‘In writing to you, we recognise the stated aim of the BMA to protect urgent and emergency care during industrial action and to maintain patient safety,’ it said.
NHS England is ‘extremely concerned’ that Christmas Day cover is ‘insufficient’ to ensure appropriate levels of patient safety are being maintained.
‘This is particularly the case in the current period of industrial action, with three consecutive Christmas Day levels of service.
‘The reasons for this are two-fold: we are not experiencing Christmas Day levels of pressure, when demand falls by around a third, nor are we seeing the drop in bed occupancy levels that occurs immediately prior to Christmas.
‘In addition, successive days of Christmas Day cover are significantly impacting on the ability of systems to maintain flow throughout our emergency pathways, which in turn is resulting in delayed ambulance handovers, deteriorating ambulance response times and long waits for patients in Emergency Departments.’
The letter, signed by workforce chief Dr Navina Evans and national medical director Professor Sir Stephen Powis, noted these issues were already raised in regular industrial action operational meetings.
But it added:’ However, in light of our responsibility to support the NHS and maintain patient safety we feel it is important these concerns are also now raised formally.’
Responding, BMA council chair Professor Phil Banfield said that the union has always been open to discussing ways to maintain patient safety.
He said: ‘We have always been open to discussing ways in which together we can maintain patient safety during industrial action, and we communicated this directly to colleagues at NHS England, most recently in a meeting just yesterday.’
He also detailed several ‘planning failures’ including that some NHS trusts ‘had not appropriately rescheduled’ non-urgent elective activity in the days leading up to strikes which has directly impacted the ability to prioritise more urgent care needs, according to the union.
He added: ‘I do not agree that the Christmas and Boxing Day model of industrial action is unsafe or that it is the reason for the issues you have detailed in your letter.
‘This model only applies to consultants and junior doctors eligible to strike. Consequently, actual staffing is higher than Christmas and Boxing Day, given SAS doctors, various non-striking consultant and junior doctors, as well as allied health professionals continue to work as normal.
‘Instead, there is clear evidence of the failure by some trusts to adequately prepare for industrial action.
‘In particular the BMA is aware that some trusts have continued with significant amounts of elective activity during industrial action and have failed to reschedule non-urgent elective care in an attempt to meet political targets. This is causing unnecessary risk of harm.’
He added: ‘As you know, no further industrial action has been called, and it is now incumbent upon the Government to come to the table, drop their refusal to negotiate on pay and settle its dispute with doctors.’
Yesterday health secretary Steve Barclay criticised the BMA in his speech to the Tory party conference, including over resistance to GP patient records access via the NHS app. Meanwhile, the BMA offered to involve reconciliation service Acas in the dispute over consultants’ pay.