For the attention of:
The Prime Minister, Rt Hon Rishi Sunak MP
Professor Philip Banfield, Council Chair, BMA
cc: Secretary of State for Health and Social Care, Rt Hon Steve Barclay MP
Dear Prime Minister and Professor Banfield,
Forthcoming industrial action in the NHS
We write as the Chairs and Chief Executives of ten of the largest teaching and research hospitals in England, ahead of the industrial action due to take place by doctors and other healthcare professionals in September and October. Collectively our organisations serve 17 million patients a year, and employ over 170,000 staff, including 24,000 doctors, representing around one in six of the hospital medical workforce.
We wish to convey our profound concerns at the risks that ongoing strikes pose to the care and safety of patients, and to call for renewed efforts from government and unions to find a path to resolution.
The immediate impact of these strikes
Across the NHS, nearly a million appointments have been delayed over the period of industrial action. In our own trusts, around 54,000 patients had an outpatient appointment postponed and more than 6,500 patients had a procedure or operation rescheduled in the most recent round of strikes over July and August. We expect the impact of the September and October strikes will be greater still. Each additional day of action strikes a further blow to the prospects for the goal we all share of reducing waiting times for patients.
While we will continue to do all we can to maintain safety, deliver emergency care and prioritise those most in need of scheduled care, delays on this scale are inevitably leading to increased anxiety for patients and families, and heightened risks of clinical harm as appointments are re-arranged, diagnosis is delayed, and treatment postponed. These harms include disease progression in time-sensitive conditions such as cancer, prolonged time in pain, and consequences for mental health and wellbeing. As we head into what we anticipate will be an immensely challenging winter, further action will increase these risks beyond the impact on elective care into our ability to maintain safe emergency services.
Furthermore, in an already tight funding environment, the immediate financial costs of industrial action are having a material impact on the resources available for improving care for the future.
The long-term damage
Not all the impact of industrial action is visible immediately. While teams in our organisations and across the NHS are performing extraordinary work to keep patients as safe as possible on strike days, the individual and cumulative harm from delayed care will show up slowly and surely over coming months. We have never before run a service on normal working days with ‘Christmas Day’ levels of medical staffing across three days in succession – each escalation of industrial action is testing the limits of what can be managed safely. Inevitably there will come a point where that limit is exceeded.
As employers, we are also seeing first-hand how these sustained disputes risk damaging the fabric of professional relationships and team working that underpins all good care. The longer action goes on, the more entrenched positions become, the more goodwill erodes, and the longer and harder the road to recovery will become.
Therefore, for the sake of patients and staff across the NHS, we urge the government, the BMA and all unions in dispute to do whatever it takes to resume negotiations and reach resolution as soon as possible.
Sincerely,
Professor Tim Orchard, Chief Executive, Imperial College Healthcare NHS Trust, and Shelford Group Chair
Matthew Swindells, Chair, Imperial College Healthcare NHS Trust
Kirsten Major, Chief Executive, Sheffield Teaching Hospitals NHS Foundation Trust, and Shelford Group Vice-Chair
Annette Laban, Chair, Sheffield Teaching Hospitals NHS Foundation Trust
Dame Jackie Daniel, Chief Executive, Newcastle Hospitals NHS Foundation Trust
Professor Sir John Burn, Chair, Newcastle Hospitals NHS Foundation Trust
Roland Sinker CBE, Chief Executive, Cambridge University Hospitals NHS Foundation Trust
Dr Mike More, Chair, Cambridge University Hospitals NHS Foundation Trust
Professor David Probert, Chief Executive, University College London Hospitals NHS Foundation Trust
Baroness Julia Neuberger, Chair, University College London Hospitals NHS Foundation Trust
Jonathan Brotherton, Chief Executive, University Hospitals Birmingham NHS Foundation Trust
Dame Yve Buckland, Chair, University Hospitals Birmingham NHS Foundation Trust
Mark Cubbon, Chief Executive, Manchester University NHS Foundation Trust
Kathy Cowell OBE DL, Chair, Manchester University NHS Foundation Trust
Professor Meghana Pandit, Chief Executive, Oxford University Hospitals NHS Foundation Trust
Professor Sir Jonathan Montgomery, Chair, Oxford University Hospitals NHS Foundation Trust
Professor Clive Kay, Chief Executive, King’s College Hospital NHS Foundation Trust
Professor Ian Abbs, Chief Executive, Guy’s and St Thomas’ NHS Foundation Trust
Charles Alexander CBE, Joint Chair, King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust