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Strike exemption requests not approved despite staffing concerns

Published on: 11 Aug 2023

Updated: Several trusts’ requests for exemptions from junior doctors strike actions — citing difficulties securing enough shifts to safely staff services — were not approved, and in one case was withdrawn by the British Medical Association.

Cambridge University Hospital Foundation Trust had been granted a limited derogation for its obstetric unit for Saturday night, the British Medical Association announced on Friday. This would have allowed striking junior doctors to be requested to return to work.

But on Saturday evening this was withdrawn, with the BMA junior doctors committee saying on X (formerly Twitter) that its withdrawal was “based on new information which was not included on the original request form”.

At least two other trusts — University Hospitals Sussex FT and the Royal Free London FT — which had begun the process of seeking derogations on Friday were never granted them.

Many local sources said they had struggled to secure cover from consultants for the shifts, likely due to the holiday period, or because willingness is waning after several strikes this year. Saturday and Sunday nights were expected to be pinch points. 

It appears UHSFT may have withdrawn its request itself, after managing to secure adequate staff for its accident and emergency departments at St Richard’s, Chichester, and Worthing Hospital over the weekend.

A message to UHS consultants sent at the end of last week said weekend cover in A&E was “problematic”, and asked for additional volunteers, with the promise of being paid at BMA “rate card” rates.

The services believed to be under pressure at the Royal Free included acute medicine and renal. The Royal Free on Friday confirmed it had declared an internal incident, and was seeking derogations due to concerns over staffing and service pressures.

In a statement to HSJ on Sunday, the BMA said that no derogations had been granted – with the Cambridge one being withdrawn – and it would not comment on any requests until they had been granted.

In the previous junior doctors strikes, only one narrow derogation is though to have been approved, while another was requested but never enacted.

BMA messages to junior doctors in other parts of the country have said derogations will not be granted if trusts failed to plan for the strike; had not cancelled elective activity; were not offering other grades of doctors the BMA’s recommended cover pay rates; or if trusts chose to declare an “incident” without consulting the doctors. The BMA has said staff will return to work in the event of a “major incident”.

HSJ understands several other trusts had been considering asking for derogations but may have decided against it or been advised that their requests would not have much chance of success.

The current junior doctors’ strike is the fifth this year and will last until 7am on Tuesday morning.