HCSA has produced the following guidance for Consultant and SAS members on how the action will affect your work on strike days.
You may also have seen advice from other organisations. Legal opinions differ and there are various interpretations of contract and employment law. HCSA is confident in our advice, which has been endorsed by the HCSA Executive Committee.
If you are in any doubt about the specific circumstances you face, we have an advice line that will be open for extended hours on strike days. Call 01256 770999 for help or email email@example.com
How will the action affect me as a non-junior?
Consultant and SAS doctors should support junior doctors to do whatever it takes to make the strike a success.
You will be required to go to work as normal on the days of action.
The working environment may be more challenging on strike days, and it’s important you work flexibly and comply with reasonable requests to maintain a safe service. More detail below.
The GMC have issued the following guidance: “Doctors may be faced with challenging situations during strike action, whether or not they're participating directly. In both scenarios, doctors will need to use their professional judgement to assess risk and deliver the best possible care for people.”
What are my responsibilities in advance of strike days?
Employers are ultimately responsible for maintaining the safe provision of their services during all times, including during strike action. Employers will receive a minimum of 14 days notice of strike action which they should use to plan for the action. Strike is not a sudden unforeseen circumstance, but a planned event.
HCSA encourages members to engage positively with Clinical Directors and Department Managers in discussions and to engage with measures which will ensure adequate cover, a safe service for patients and safe working for themselves. Clinical Directors and Department Managers should consider which services can and cannot operate safely on strike days, instead of relying on non-contractual work to maintain all services.
HCSA also encourages you to reassure junior doctor colleagues in the period before strike action, so they understand that the rest of the medical profession is supportive.
What are my responsibilities on strike days?
It is important that senior doctors work in whatever safe way they can, suited to their competencies, to ensure emergency patients stay safe, that they take every step possible to keep patients safely treated in areas and levels of practice in which they are competent and trained, and that they make sure they do not become overcommitted and leave other areas vulnerable as a result.
All doctors are expected to be flexible and to co-operate with “reasonable requests” from line managers. You may also be asked to deputise for colleagues who are absent, where it is safe and practicable to do so. You may well be asked to cover/perform the duties of a colleague who is taking industrial action. In many instances this could be interpreted as a reasonable request. Refusal to carry out such a request could result in your employer taking disciplinary action.
However, clinical safety is a key factor in deciding what constitutes a “reasonable” request. It would not be reasonable to expect a hospital doctor to undertake duties that they are not qualified to perform, or to be asked to carry out duties that would result in an individual being too tired or overburdened to work safely.
In what ways can I expect my duties to change on strike days?
We can expect Consultants and SAS doctors to be asked to provide first on-call cover and possibly, resident on-call cover, not to take leave that may have been booked, as well to rearrange supporting professional activity time. Part-time Consultants and SAS doctors could be asked to rearrange their days of working to facilitate cover.
If you were due to be undertaking supporting professional activity (SPA) then that activity could be rescheduled for a later date and you should be paid for direct clinical care that you undertake on the day. There is no strict entitlement to this, but it represents a practical solution which ensures valuable SPA time is not lost. Be aware that if you were scheduled to be, for example, doing a period of CPD, paid time must be made available in future for you to do that CPD. If you are working resident at night, then you should not work during the day or the next day and should be paid as per existing policy.
If a patient is at risk, any refusal to cooperate in assisting with that patient is likely to be considered unreasonable, meaning that you will be more vulnerable to disciplinary action than if the request was to undertake work that was not clinically urgent or was not clinical in nature at all.
If you are covering the work of a junior colleague, you must remember that you are still employed as a consultant or SAS doctor but are working at a lesser level of skill or responsibility than you do normally.
If you are expected to use systems, such as electronic prescribing or discharging systems, which you are unfamiliar with you should raise this with your employer who may provide training and support to consultants and SAS doctors.
If you are undertaking work outside of your normal duties, these must be within your competencies and if they are of a lesser level of skill requirement or responsibility you should still be paid at your normal rate of pay.
You cannot be expected to undertake the work of multiple people as this would not constitute a safe working practice.
Should I do extra non-contractual work during a Junior Doctors strike?
HCSA Council is of the view that senior doctors should avoid extra non-contractual work during the junior doctors’ strike. This is because working more than usual could lessen the impact of the junior doctors’ strike.
However, you have an obligation to comply with reasonable requests to ensure a safe service, which could in some cases require non-contractual work, for example within maternity or ICU. In these cases, we advise you seek to reach an agreement with your employer to rearrange the rota to facilitate this within your contractual hours and ensure time can be taken back as Time Off In Lieu (TOIL) as soon as possible.
If the provision of a safe service requires you to do extra non-contractual work, this should be paid at the locally agreed enhanced rate. If you receive additional pay for working extra during the junior doctors’ strike, HCSA encourages you to put this into the strike fund.
What happens when the strike finishes?
When the strike period finishes, please remember the importance of continuity of care and communication with colleagues, and the following guidance from the GMC’s Good Medical Practice: “You must contribute to the safe transfer of patients between healthcare providers and between health and social care providers.”
This means you must:
- share all relevant information with colleagues involved in your patients’ care within and outside the team, including when you hand over care as you go off duty, and when you delegate care or refer patients to other health or social care providers
- check, where practical, that a named clinician or team has taken over responsibility when your role in providing a patient’s care has ended.
This may be particularly important for patients with impaired capacity or who are vulnerable for other reasons. “If you have undertaken duties outside of your normal duties during the period of industrial action, you must be mindful of your duties with regard to ensuring continuity and good communication if handing back care to another doctor”.
How else can I support the junior doctors in their dispute?
- Donate to the strike fund here: https://support-doctors-strike.raisely.com/
- Reassure the junior doctors you work with that you are supportive of their action
- Visit junior doctor picket lines to show support on days of action
- Send supportive messages on your social media channel and tag @HCSANews
- Ask your LNC or MSC to write a letter of support
- Signpost to HCSA Junior Doctor FAQs
If you have are facing a workplace situation that you need support with, phone HCSA on 01256 770999 for help or email firstname.lastname@example.org . We will be operating an extra out-of-hours service during the strike period.