Patients could face ‘harm’ in coming weeks – medics

The warning comes as junior doctors in England stage the longest strike in NHS history.

NHS officials have said that the impact of the strike could be felt for weeks or months as services try to catch up on lost time due to strike action.

But a senior medic has warned that even the usual winter pressures could cause turmoil in the service.

Dr Tim Cooksley, immediate past president of the Society for Acute Medicine, said patients would be subject to “corridor care” and those in ambulances could face long waits outside hospitals.

He also warned that patients could face “significant harm and trauma due to delayed ambulance responses”.

“A continuum of often predictable perfect storms has caused a struggling system to reach collapse,” Dr Cooksley wrote in an editorial published in The BMJ.

It comes as pressure in the system started showing just hours into the start of the junior doctors’ strike with a number of hospitals declaring critical incidents and others warning of significant A&E waits.

A number of hospitals pleaded for junior doctors to leave picket lines and return to work amid patient safety fears – also known as derogation requests.

But a row erupted between NHS officials and the British Medical Association after the doctors union said that the derogation process was being “undermined” by the health service and it suggested that the requests were being made due to “political pressure”.

When making such requests NHS trusts are expected to show they have “exhausted” all other sources of staffing before recalling medics.

More than 20 derogation requests have been submitted to the union, but so far none have been approved as the union said that NHS England and some trusts are refusing to provide evidence that they have undertaken these steps.

In a letter to NHS bosses, BMA chairman Professor Philip Banfield, said: “This refusal to provide the information necessary to take well informed decisions is fundamentally undermining the derogation process as we are being asked to take decisions about our members’ right to strike without the requisite information. NHS England, it seems, is wilfully placing the BMA in an impossible situation.

“We are increasingly drawing the conclusion that NHS England’s change in attitude towards the process is not due to concerns around patient safety but due to political pressure to maintain a higher level of service, undermine our strike action and push the BMA into refusing an increasing number of requests – requests, we believe, would not have been put to us during previous rounds of strike action.”

But the NHS Confederation, which represents NHS organisations, said that hospitals needed to “limit the precious time they and their teams have available to filling in forms when patient safety could be at risk”.

Matthew Taylor, chief executive of the NHS Confederation, said: “NHS trusts have been working at pace to prepare for these strikes, which come during one of the busiest weeks of the year for the health service.

“They are dealing with rising levels of winter viruses in the midst of industrial action and higher than anticipated staff sickness.

“A number of trusts have already declared critical incidents, with pressure likely to get worse as the walkout continues this week.

“Rather than accusing hospital leaders of refusing to provide the required information in full to the BMA, this is more about them needing to limit the precious time they and their teams have available to filling in forms when patient safety could be at risk.”

An NHS England spokesman said: “Given this period of industrial action coincides with the most difficult time of year for the NHS, it is to be expected that more senior medical leaders will ask their colleagues for allowances to be made to ensure safe levels of cover.”

On the first day of the strike, critical incidents were declared at Queen Alexandra Hospital in Portsmouth and by the NHS in Nottingham.

Meanwhile more than a dozen hospitals said that emergency services were busy, with some reporting “extreme heightened pressure”.

It comes as a new poll revealed that elderly people are less sympathetic towards the strike compared to younger people.

The survey of 1,500 British adults, conducted by OnePoll, found that 29% of people aged 65 and over said they were “not at all sympathetic” to the strike, compared with just 4% of people aged between 18 and 34.

Jim Easton, chief executive of Practice Plus Group, which commissioned the survey, said: “Older people are more likely to be at a stage in their lives where they’ve paid their taxes and national insurance their whole working lives and are frustrated and disappointed that now they are reaching an age where they’re more likely to need the NHS, it’s in crisis.”

The BMA has said junior doctors’ pay has been cut by more than a quarter since 2008.

Last summer, the Government gave junior doctors in England an average rise of 8.8%, but medics said the increase was not enough and ramped up strike efforts.

Late last year, the Government and junior doctors entered talks, but after five weeks, the negotiations broke down and more strikes were called.

Junior doctors from the Hospital Consultants and Specialists Association union will join colleagues on picket lines.

Consultants and SAS doctors have agreed on a deal with the Government, which is being put to members.