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An open letter to both to Government & the BMA states ‘It is now imperative that both Government and the BMA find a resolution and bring an end to their dispute’.

Published on 20 December 2023 09:38 AM

Five organisations representing NHS leaders and patients have jointly written to the Chair of the Council of the BMA and to the Secretary of State of the Department of Health & Social Care stating concerns about the on-going industrial action within the NHS.

The organisations, including Age UK, Healthwatch, NHS Confederation, National Voices and the Patients Association, are seriously concerned about plans for industrial action set to take place between 20 and 23 December, and for a further six days in early January 7am on 3 January to 7am on 9 January 2024.

Collectively the organisations are calling on both Government and the BMA to get back to the negotiating table, believing that further strikes would be a major blow for the service already grappling with record waiting lists, winter pressures and the financial fall out of previous industrial action.

In the first week of December there were already 13,000 patients – many older people – waiting to be discharged. Strike action in the run up to Christmas could see these numbers increase, leaving patients stranded in hospital over the holiday period despite being medically fit for discharge.

Over the course of 2023 we have seen more than 1.2 million operations and appointments cancelled and £1.4 billion spent by NHS organisations, including on additional staff costs, as they have sought to keep essential services running.

Meanwhile, waiting lists have increased by 510,000 from 7.2 million in January to 7.71 million in October 2023. These lists have already impacted on the health of patients, families and carers while they wait for essential treatment or struggle to access the on-going support, they need to manage health conditions. And, it is most disadvantaged communities and vulnerable patients who pay the highest price for disruption and delays.

Despite the best efforts of hard-working NHS staff, the organisations are concerned that it will be extremely difficult to ensure safe and effective care during this period for all patients that need it. Winter pressures, staff absence and high levels of patient demand, mean the first weeks of January are typically one of the busiest times, particularly for urgent and emergency care services.

Nine months have now elapsed since the BMA Junior Doctor’s Committee first embarked on industrial action in March 2023. The timing, duration and fact that – as yet – no national derogations have been agreed is cause for alarm.

It is now imperative that both Government and the BMA find a resolution and bring an end to their dispute.

It is not too late to restart talks and avert further disruption.

Caroline Abrahams, Charity Director at Age UK said:  "Ever since the industrial action in the NHS began, we have been hearing from distressed older people about how their outpatient appointments and operations scheduled for strike days have had to be postponed, sometimes for months, and for some unlucky people on more than one occasion. Make no mistake, these postponements have had real consequences for them by slowing down the diagnosis of serious illnesses, as well as delaying surgery to deal with cataracts and degraded hip and knee joints that seriously interfere with daily life and often cause them ongoing pain.  

“Although the NHS strikes that have occurred to date have seriously impacted all those caught up in them, the extended duration of the new ones planned for before and after Christmas, the busiest time of the year in the NHS, poses a much greater potential threat to older people’s health and wellbeing. We fear this planned industrial action will not only adversely affect older people stuck on waiting lists or due a clinic appointment, but also those in hospital and others who might need to be admitted over the holiday period.  With the best will in the world, it is hard to guarantee patient safety and wellbeing if you are operating a hospital with a skeleton clinical staff, one that will already be being depleted by staff sickness and annual leave. 

“Even at this stage however it’s not too late for the Government and the unions to get round the table and forge an equitable agreement to bring this dispute to an end. The longer it goes on and the more intensive and extended the industrial action taken, the greater the potential risk to patients, among whom older people form the biggest group. Enough is enough, it's high time there was a settlement.” 

Louise Ansari, Chief Executive, Healthwatch England, said:

“The forthcoming strikes will be concerning for patients already facing long waits for care, especially now we are in winter when demand will be higher. We know that waits affect some worse than others. If you are a woman, on a low income, from an ethnic minority background or have a disability, you are more likely to have a worse experience of waiting for care. 

“It essential that both parties find a way forward to prevent the confidence of patients being undermined when it comes to being able to access care. It also vital that lifesaving care is not affected and that the NHS gets its communications right to ensure that patients know if services will be affected.”

Jacob Lant, chief executive of National Voices said:

“The length of waits many people are now facing are very serious, and last-minute postponements can be devastating for patients and their loved ones. And it is often those who are least able to cope with a delay who are the ones bearing the brunt.”

 Matthew Taylor, chief executive of the NHS Confederation said:

“Without urgent action the NHS faces a grim Christmas and New Year. Despite doing all they can to prepare for an already very challenging winter, NHS leaders are now having to contend with fresh strike action by junior doctors over what will be some of the busiest days of the year.

“Any strike is highly disruptive but worse still there is no agreement on national derogations. Without this agreement for doctors to provide urgent and critical ‘life and limb’ cover, the risk to patient safety, and strain on other staff, is further heightened.

“We can only hope that the government and the BMA find a way through this impasse quickly. We desperately need a resolution, or failing that, a basis for the postponement of action during winter.”

Rachel Power, Chief Executive of the Patients Association, said:

“Patients should have access to safe and effective care when they need it. Strikes create barriers to care over and above the long waits many patients are already experiencing. While our focus is on patients, we are also concerned about the impact the strikes will have on the wider NHS and staff. Both the BMA and Government need to find a way through this impasse and find a solution now.” 

The Letter was sent to the Secretary of State of Dept of H& SC & the BMA’s Chair of Council:

 

19th December 2023

Dear Professor Banfield,

We are writing to you as BMA Chair of Council regarding on-going industrial action in the NHS. We have also addressed this letter to the Secretary of State for Health and Social Care.

As organisations representing both patients and NHS leaders, we are seriously concerned about plans for industrial action set to take place between 20th and 23rd December, and for a further six days in early January. The timing, duration and fact that – as yet – no national derogations have been agreed is cause for alarm. As a minimum, we are calling on all parties to take a step back and agree national derogations in our most vital ‘life and limb’ services so they can continue to operate in full over the period.

It is well understood that this is already a time of year when services come under immense pressure. There were 13,000 patients – many older people – waiting to be discharged in the first week of December. Strike action in the run up to Christmas could see these numbers increase, leaving patients stranded in hospital over the holiday period despite being medically fit for discharge. At the same time, a combination of seasonal pressures on primary and community care, staff absence and high levels of patient demand mean the first weeks of January are typically one of the busiest times, particularly for urgent and emergency care services. Taken together, our concern is that, despite the best efforts of hard-working NHS staff, it will be extremely difficult to ensure safe and effective care during this period for all patients that need it.

Already over the course of 2023 we have seen more than 1.2 million operations and appointments cancelled and £1.4 billion spent by NHS organisations, including on additional staff costs, as they have sought to keep essential services running. Meanwhile, waiting lists have increased by 510,000 from 7.2 million in January to 7.71 million in October 2023. There are currently 9,000 referrals on the list that have been waiting for more than 18 months. We are deeply concerned about the consequences for patient care. 

We have all heard from and seen the impact on patients, families and carers whose health has deteriorated while they, or their loved ones, wait for essential treatment or struggle to access the on-going support they need to manage their health condition. We are also keenly aware that it is our most disadvantaged communities and vulnerable patients who pay the highest price for disruption and delays. Work by the King’s Fund found that those living in the most deprived communities already wait around twice as long for elective care, with further work by Healthwatch England highlighting that longer waits have a more detrimental impact on the physical and mental wellbeing of women, people with disabilities, those on low incomes and those from ethnic minority communities.   

This position is clearly unsustainable for staff, NHS leaders and patients alike. Nine months have now elapsed since the BMA Junior Doctor’s Committee first embarked on industrial action in March 2023, with negotiations and discussions taking place for some time before that. It is now imperative that both Government and the BMA find a resolution and bring an end to their dispute. 

Further strikes would be a major blow to a service already grappling with record waiting lists, winter pressures and the financial fall out of previous industrial action. 

We are collectively calling on both Government and the BMA to get back to the negotiating table. It is not too late to restart talks and avert further disruption. 

Yours sincerely,

Paul Farmer
Chief Executive, Age UK

Mathew Taylor   
Chief Executive, The NHS Confederation

Louise Ansari 
Chief Executive, Healthwatch England

Rachel Powers 
Chief Executive, The Patients Association

Jacob Lant
Chief Executive, National Voices

 

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Last updated: Dec 20 2023

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