Industrial action in the NHS: advice and FAQs for members
Junior doctors in England have voted to take industrial action. The first 72-hour walkout took place from 13-15 March 2023. A further 96-hour walkout is due to take place from 11-15 April 2023.
We want to support our members during this time and have put together this information, which includes some frequently asked questions and signposting to further guidance and support. Although the College and Faculties do not have a role in negotiations about our members’ terms and conditions of service, we recognise the right of doctors and other healthcare professionals to take industrial action, and we understand why many may wish to do so.
Key organisations and resources
The British Medical Association (BMA)
The BMA has confirmed that junior doctors voted for industrial action in its ballot from 9 January to 20 February, with a 77% turnout and 98% voting ‘Yes’. The BMA’s first round of action was a 72-hour walk out on 13, 14 and 15 March, with junior doctors advised not to attend any shifts between 6.59am on 13 March and 06.59 on 16 March.
On the 23 March, the BMA announced a second round of action - a 96-hour walkout of all junior doctors in England on 11, 12, 13 and 14 of April. It is advising junior doctors not to attend any shifts between 06.59am on 11 April and 06.59am on 15 April.
The BMA has published a Junior doctors’ guide to strike action on its website, which includes the latest information and advice and FAQs relating to picketing, maternity pay, and next steps.
In addition, on 6 March, the BMA said it would ballot consultants for industrial action from 'next month', following a consultative ballot in which 86% of senior hospital doctors indicated they would back strike action.
A ballot of junior doctors in Scotland on strike action will open on Wednesday 29 March.
The Hospital Consultants and Specialists Association (HCSA)
The HCSA has confirmed that its junior doctor members have voted for industrial action in its ballot, with a 97% voting in favour on a 75% turnout. The first HSCA strike action took place at the same time as the BMA’s – on the 13, 14 and 15 March.
On 23 March, the HCSA announced strike action at the same time as the BMA's second action, with its junior doctor members due to walk out from shifts starting from 06.59am on 11 April until 06.59am on 15 April.
The HSCA has published key information about the junior doctors’ dispute in England on its website.
General Medical Council (GMC)
The majority of our UK members will be regulated by the General Medical Council. The GMC has set out a short briefing on their ethical hub with guidance around industrial action.
Frequently asked questions (FAQs)
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 the same days as the 96-hour walkout by junior doctors (11-15 April 2023).
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.
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.
We understand that some of our members are losing income because of the industrial action, and we want to help where we can. If you usually make an annual payment by credit/debit card or online transfer, you could consider changing to a monthly direct debit, which allows you to spread the cost. All you need to do is download and print the monthly direct debit instruction form and send a scan or photograph of the completed (signed) form to firstname.lastname@example.org by 12 April .
If you do this now, your fee will be spread over 11 months rather than 12 for the first year, with the first payment collected in May 2023. If you submit your form after 12 April your fee will be spread over 10 months, with the first payment collected in June 2023.