Industrial action in the NHS: advice and FAQs for members

Our core focus is on working with members to ensure the quality of patient care through maintaining standards in anaesthesia, critical care and pain medicine. We support our members though all stages of their career, including working to enhance education and training.

While we don’t have a role in the negotiation of our members’ terms and conditions of service, we do advocate for the things that matter to them. For example, we continue to campaign for the government to increase the number of doctors, address working conditions and ensure staff are appropriately valued and supported so that they can uphold standards of patient care. This includes urging the government to consider the impact of its pay deal, which we believe will exacerbate the NHS staffing crisis. 

The Review Body on Doctors’ and Dentists’ Remuneration (DDRB) is the independent body which makes recommendations on the remuneration of doctors and dentists in the NHS. These recommendations are sent to governments across the UK. The DDRB published its recommendations in July 2022. The Government accepted the recommendations and offered a below inflation 4.5% pay award to some groups of doctors for 2022/23. More information on this year’s pay round and what this means for doctors in the NHS can be found on the BMA website.

Everyone in the UK has a right to take lawful industrial action, as outlined and defined by the Government. We suggest you speak with your union to discuss any personal circumstances or questions in more detail, and potentially your employer. The BMA provides guidance for international medical graduates (IMGs) working in the UK on a health and care visa under a certificate of sponsorship from a licensed sponsor, which includes links to its Immigration Advice Service phone line and email support. You can also watch the BMA’s webinar on visas and industrial action for international doctors.

The best way to manage your portfolio is to keep up to date as you go along. Try to make the most of quieter times to get ahead with assessments and portfolio updates and plan ahead for the industrial action days.

Think about what you might miss and how this might be rearranged to achieve the capabilities you require to meet the curriculum. We suggest early consultation with your supervisor if you feel you may experience problems keeping up in this way.

As a doctor in training, the decision to take part in industrial action in and of itself should not affect your relationship with your supervisors or your Annual Review of Competency Progression (ARCP) outcome.

At ARCP, time out of training, including taking industrial action, must be declared on your form R, as outlined in the Gold Guide. For those in Core/Speciality training, if you take more than 14 days out of training (when you would normally be at work), a review will be triggered of whether you need to have your CCT date extended, as set out by the GMC. This review would normally occur at your ARCP and extension is not automatic.

This applies whatever the reason for time out of training and includes days taken for sick leave or industrial action. If you are concerned that you have missed training opportunities due to time out of training, you should discuss with your supervisor or Training Programme Director. We encourage anaesthetists in training to evidence their learning in their ePortfolio and find training opportunities now, in preparation for potentially missing training opportunities due to industrial action.

In its 2012 position statement (PDF), the GMC outline that within each 12-month period where a doctor in training has been absent for a total of 14 days or more (when a trainee would normally be at work), this will trigger a review of whether the trainee needs to have their CCT date extended. Make sure you keep track of the time you have taken out of training so you can discuss with your Educational Supervisor and at your ARCP panel. 

Some specific and formal training opportunities may have to be deferred during times of service disruption whether that is due to industrial action or unusual service pressures. This may be unavoidable to maintain patient safety, and we know that training often needs flexibility; however, we would expect training units and schools to facilitate catch up of any outstanding training once things settle down. This might include prioritising clinic attendance or re-scheduling clinical commitments to take the opportunity to acquire specific technical capabilities. Please talk to your supervisor and/or Training Programme Director (TPD) if you feel your training has been affected.

Doctors in training should continue to exception report for missed training opportunities, even when this is unavoidable due to exceptional service pressures. This helps departments to evidence training and service gaps and work towards solutions.

There are no FRCA, FFICM or FFPM exams scheduled on any of the strike days currently announced. 

In general, the BMA has advised doctors who have an exam on a day of industrial action that, if the exam is going ahead, they are able to sit the exam and take part in industrial action activities around that.

We recommend you read Health Education England’s guidance for the national recruitment rounds taking place during the period of industrial action.

• Plans for managing specialty recruitment during junior doctors industrial action scheduled for Monday 13 March to Thursday 16 March
• Industrial action and management of doctors in postgraduate training (particularly the sections on national recruitment interviews and interviews in devolved nations)

The BMA has a free and confidential 24/7 counselling and peer support service open to all doctors and medical students (regardless of BMA membership), plus their partners and dependents.

The NHS has a confidential text support service, which you can access by texting FRONTLINE to 85258 for support 24/7. You can also use the NHS free and confidential self-check tool to access further information on the range of support offers that are available.

Practitioner Health is a free, confidential NHS Primary care mental health and addiction service with expertise in treating health and care professionals.

The Royal Medical Foundation aims to assist GMC-registered doctors and their families in financial hardship. The BMA Charities Trust Fund can provide money advice for any doctor who is having difficulty managing financially.  

The Academy of Medical Royal Colleges has a longer list of other organisations that may be able to help.

The GMC states that patient safety must be assured during industrial action and that the principles of Good Medical Practice should be adhered to. This means that supervision levels for clinical work should remain the same as normal and that no anaesthetist in training should be asked to work without adequate supervision. Activity should therefore reflect the availability of consultants and other autonomously practising anaesthetists to provide such supervision.