Amanda Pritchard has thanked junior doctors who “returned to work to ensure minimum levels of cover” during last week’s strike, “whether or not formal patient safety mitigations were granted” by their union, along with others who helped “keep patients safe”.
It follows a row between the British Medical Association and NHS England last week over the approval of local exemptions from strike action, also known as “mitigations” or “derogations”.
They can be granted by unions to permit striking members to return to work, but only where the BMA decides its conditions are met, and very few have been granted during the current dispute.
The BMA on Friday said two derogations had been granted, for “one junior doctor for the neonatal unit at University Hospital Lewisham for the day shift on 5 January”, and “for one (junior) doctor for the obstetric unit at Nottingham University Hospitals Trust for the night shift on 5 January”.
In a weekly message to local NHS leaders this morning, the NHSE chief executive said: “The latest period of industrial action has inevitably brought with it extensive comment, coverage and conflict.
“But for those of us in the NHS, the real story has once again been one of countless professionals – both clinical and non-clinical – displaying conspicuous resilience in the face of incredible pressures.
“I’ve heard accounts of colleagues all the way from the frontline to service and board directors working around the clock – and in unfamiliar settings – to keep services running and patients safe. I include in that the many junior doctors who have chosen not to take action, or who have returned to work to ensure minimum levels of cover, whether or not formal patient safety mitigations were granted.”
However, she said “repeated periods of ever more drastic action” were not “sustainable”, and “it is inevitably patients – many needing time-sensitive treatment – who are left shouldering the greatest personal risk”.
Last week, BMA council chair Phillip Banfield accused NHSE of the “weaponisation” of the derogation process, saying trusts had submitted multiple requests but were not providing the information needed to determine if they were justified. Its conditions include that trusts have cancelled planned care, and sought to get staff cover elsewhere.
In response, NHSE denied this and said it would start recording harm caused to patients during strike action where exemptions have been rejected or not replied to by the BMA.
Concerning the granting of derogations, the BMA has said its “priority is patient safety”.