Sunak backs NHS leaders asking striking doctors to return to work

A number of hospitals in England have pleaded for medics to return to work due to safety concerns – also known as derogation requests.

But a row erupted after the British Medical Association (BMA) said that the derogation process was being “undermined” by the health service and it suggested that the requests were being made due to “political pressure”.

Rishi Sunak said that NHS leaders are “completely independent of Government” but added that they have his “backing” when making such requests.

Speaking to broadcasters in Nottinghamshire, he said: “The NHS is responsible for patient care and it’s right that they do absolutely everything they can to ensure patient care.

“These strikes are disrupting people’s lives. They are causing an enormous amount of concern to people.

“It’s absolutely right that NHS leaders, completely independent of Government, are making clinical decisions on the ground. And requesting that extra support where they feel that they need it. Of course they have my backing in doing that.”

When making derogation requests NHS trusts are expected to show they have “exhausted” all other sources of staffing before recalling medics.

More than 20 derogation requests have been submitted to the BMA, but so far none have been approved as the union said that NHS England and some trusts are refusing to provide evidence that they have undertaken these steps.

In a letter to NHS bosses, BMA chairman Professor Philip Banfield, said: “This refusal to provide the information necessary to take well informed decisions is fundamentally undermining the derogation process as we are being asked to take decisions about our members’ right to strike without the requisite information. NHS England, it seems, is wilfully placing the BMA in an impossible situation.

“We are increasingly drawing the conclusion that NHS England’s change in attitude towards the process is not due to concerns around patient safety but due to political pressure to maintain a higher level of service, undermine our strike action and push the BMA into refusing an increasing number of requests – requests, we believe, would not have been put to us during previous rounds of strike action.”

But the NHS Confederation, which represents NHS organisations, said that hospitals needed to “limit the precious time they and their teams have available to filling in forms when patient safety could be at risk”.

Matthew Taylor, chief executive of the NHS Confederation, said: “NHS trusts have been working at pace to prepare for these strikes, which come during one of the busiest weeks of the year for the health service.

“They are dealing with rising levels of winter viruses in the midst of industrial action and higher than anticipated staff sickness.

“A number of trusts have already declared critical incidents, with pressure likely to get worse as the walkout continues this week.

“Rather than accusing hospital leaders of refusing to provide the required information in full to the BMA, this is more about them needing to limit the precious time they and their teams have available to filling in forms when patient safety could be at risk.”

In response to Professor Banfield, NHS England bosses said in a letter that it was “regrettable that the BMA calls into question the integrity and motive of local clinical leaders” who are requesting patient safety mitigations.

They said: “We will continue to engage with the BMA in good faith to ensure the safety of patients. Your letter suggests that in spite of our best endeavours, the process for considering patient safety mitigations is not working as well as it should to achieve this aim. We are keen to work with your officials to address this.”

NHS England said it would be making a number of changes, including providing a time frame for any future mitigation requests; following up with trusts which have had mitigations rejected by the BMA, or where they have not been considered in a timely fashion; and reinforcing the requirement for providers to record any patient safety incidents, and to specifically report those which occur during periods of industrial action to regional teams.

An NHS England spokesman said: “Given this period of industrial action coincides with the most difficult time of year for the NHS, it is to be expected that more senior medical leaders will ask their colleagues for allowances to be made to ensure safe levels of cover.”

Danny Mortimer, chief executive of NHS Employers, told BBC Radio 4’s World at One programme: “We’ve been crystal clear today with the BMA that these are clinical, not political, interventions. These are requests being made by senior doctors.”

Junior doctors in England are staging a six day walk out – the longest strike in NHS history.

Pressure in the system started showing just hours into the start of the junior doctors’ strike with a number of hospitals declaring critical incidents and others warning of significant A&E waits.

On the first day of the strike on Tuesday, critical incidents were declared at Queen Alexandra Hospital in Portsmouth and by the NHS in Nottingham.

Meanwhile more than a dozen hospitals said that emergency services were busy, with some reporting “extreme heightened pressure”.

Health officials have warned that the strike comes as the NHS faces one of the busiest weeks of the calendar year due to a rising tide of winter bugs and people storing up problems over the Christmas break.

Mr Sunak said people should still seek help when they need it as he urged junior doctors to “get round the table”.

He said: “Anyone who needs emergency treatment should just contact their health service as they normally would. But what it does highlight is the damage that these strikes are having.

“At this point, every other part of the NHS workforce has found a sensible, fair agreement with the Government including nurses, midwives, paramedics, consultants, doctors and specialty doctors.

“It’s only the junior doctors who are now on strike and I would urge them to get round the table so that we can resolve this, and bring an end to this disruption and the impact it is having on more people up and down the country.”

NHS officials have said that the impact of the strike could be felt for weeks or months as services try to catch up on lost time due to strike action.

The BMA has said junior doctors’ pay has been cut by more than a quarter since 2008.

Consultants and SAS doctors have agreed on a deal with the Government, which is being put to members.