On the first day of a six-day strike by junior doctors in England, NHS bosses made over 20 requests for these striking doctors to be allowed to cross the picket line and help out services. However, the British Medical Association (BMA) has not granted any of these requests. The union has accused NHS bosses of misusing the system known as derogation and bowing to political pressure to undermine the strike. NHS England has stated that they were genuine requests for help and that the health service was under enormous pressure during the walkout. NHS bosses are trying everything to protect patients and keep struggling services safe.
The requests were made by individual departments, so some NHS trusts are believed to have made more than one request. Most requests involve emergency care areas, such as A&E units. This is the ninth walkout by junior doctors, and before this stoppage, only a few requests had been made. Only one of these requests was granted temporarily to Somerset’s Weston General Hospital in April when the BMA said they were misled about the scale of the problem.
In a letter to NHS England boss Amanda Pritchard on Wednesday, BMA leader Prof Philip Banfield said that in many cases, NHS bosses provided insufficient information to judge the merits of the request. He added that this lack of information was “undermining” the derogation process and placing the BMA in an impossible position. NHS trusts that made requests have not been named. However, it is clear several areas are facing difficulties. Routine services have been scaled back to allow senior doctors to be drafted across to emergency care to provide cover, but multiple NHS trusts have reported significant waits in A&E, and some have declared a critical incident.
Warwick Hospital has warned that it is under “extreme heightened pressure,” while Airedale Hospital said its emergency department was “exceptionally busy.” Health officials in East Sussex, South Tees, Gateshead, Greater Manchester, Berkshire, Rotherham, and Harlow in Essex also reported being “busy.” Cheltenham A&E has been closed with patients being diverted elsewhere, and Bolton NHS Foundation Trust says it is facing “extreme pressure” with waiting times in A&E of “up to 11 hours.” Queen Alexandra Hospital in Portsmouth also said its A&E department was “full” as it declared a critical incident, its third in three months.
The derogation process is designed to minimally impact patients during the strikes. However, by making so many requests for junior doctors to be allowed to break the strike picket line to deal with an ongoing shortfall in staffing levels, NHS bosses are attempting to undermine the industrial action. At the same time, the BMA has a responsibility to balance industrial action with maximizing the safety of patients. The ongoing dispute over pay and workloads has yet to be resolved
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