Classification: Official
Publication reference: PRN01402
To:
- Integrated care boards:
- chief executives
- chief operating officers
- chairs
- chief people officers/human resource (HR) directors
- Medical directors
- directors of nursing
- Trusts:
- chief executives
- chief operating officers
- chief people officers/HR directors
- medical directors
- directors of nursing
cc:
- Regional:
- directors
- performance and improvement directors
- medical directors
- directors of nursing
- heads of emergency preparedness, resilience and response (EPRR)
Dear Colleagues,
Pre-action self-assessment, rescheduled activity, and workforce data collections for industrial action by Junior Doctors and Hospital Dental Trainees 7am 27 June – 7am 2 July 2024
This letter provides information on NHS England’s approach to pre-action self-assessment and workforce and rescheduled activity reporting ahead of upcoming industrial action by the British Medical Association (BMA) and British Dental Association (BDA). This action will take place from 7am 27 June until 7am 2 July 2024.
The BMA has announced a full withdrawal of labour by junior doctors, and the BDA has announced a full walkout by hospital dental trainees at 25 eligible trusts. Effective management will require clear and honest communication between staff, management, and local negotiating committees informed by comprehensive clinical risk assessments.
Expectations for trust and integrated care board planning
Trusts and integrated care boards (ICBs) must focus their planning on patients with urgent needs, such as those with deteriorating conditions, and critical services. This includes ensuring adequate staffing for all urgent and emergency care pathways, elective surgeries, maternity services, and other critical areas.
The length of disruption will cause a significant reduction in elective activity. Urgent elective surgery (P1 and P2) including but not limited to trauma, cardiac, corneal transplant, and cancer care should be protected where possible. A particular focus should be on patients who have already been diagnosed with cancer awaiting the next stage of their pathway. Long waiters should be the final cohorts to be rescheduled.
Proactive discharge of patients who are ready and effectively managing bed occupancy are crucial – both in the run-up to and during strike action. We encourage organising MADE-style events and fully leveraging community response, intermediate care, falls prevention, and Enhanced Health in Care Homes programmes. Close collaboration with local authorities to facilitate discharges throughout the strike period is also essential.
ICBs should ensure that primary and community services are prepared to offer extended support, focusing on enhanced discharges, and supporting as many patients as possible in community or home settings utilising services like urgent community response.
Local planning should account for major events (e.g. concerts or mass gatherings) and seasonal factors that are likely to increase demand on services or staffing or increase risk.
Patient safety mitigations (PSMs) and staff recall
NHS England will discuss the process for patient safety mitigations (PSM) requests with the BMA and will share further information about the process and criteria as they become available.
Trusts and ICBs should not plan on the basis that any PSM requests will be agreed.
Both the BMA and NHS England continue to recognise the necessity of staff returning to work where unexpected major incidents (that are not related to workforce demands as a result of industrial action) occur. The principles of the joint BMA NHS England letter of December 2023 remain valid in this regard for the upcoming strike action.
Trusts and ICBs should work with BMA representatives to ensure effective mechanisms are in place to contact required staff rapidly and efficiently in the event of a recall to work.
Communications
Pre-election guidance for NHS organisations has been issued ahead of the General Election. During this period, all communications should adhere to these guidelines. Communications about industrial action should remain factual, provide clear instructions for patients, and prioritise patient safety. While it is appropriate for NHS organisations to proactively communicate with the public and patients ahead of any industrial action, communications should not discuss the dispute or political issues.
Pre-action self-assessment – ICB requirement and deadlines
ICBs are requested to complete a pre-action self-assessment using the template provided to help identify areas of risk and inform national decision-making and support.
Initial feedback on readiness and risks will be conducted and collated through existing regional and national incident planning and management meetings.
Areas of highest concern will be highlighted early at the national IA Working Group meeting on Friday 21 June, and verbal ICB by ICB updates on plans, readiness, risks, and areas for national support will be subject to check and challenge on Monday 24 June 2024.
A written return will then be required from each ICB detailing their near final position. Regional colleagues will be in touch with ICBs to confirm the exact date and timings for ICBs to submit their returns to their Regional Operations Centre (ROC). These written ICB self-assessment returns will be reviewed by regional and national teams and discussed at the national IA Working Group on Wednesday 26 June 2024.
Pre-action self-assessment – regional role
Regional Operations Centres (ROCs) are asked to work with their regional EPRR colleagues to ensure a comprehensive and accurate overview of local preparations and to identify service and geographical areas of concern across all ICBs.
Where ICBs indicate there are trusts or services of concern and the return lacks detailed information, the ROC or other NHS England regional colleagues should contact the ICB for further details.
Situation report (SitRep) data collections
NHS England will conduct two data collections via the Strategic Data Collection Service (SDCS):
a. Industrial action rescheduled activity SitRep:
- reports on activities rescheduled due to industrial
- is open to all acute, community and mental health
- screenshots of the templates are shown in Annexes A, B and C and guidance for completion can be found in Annex E.
b. Industrial action workforce SitRep:
- includes the total number of doctors in training (headcount) participating in the industrial action on each strike day (excluding those absent due to TOIL accumulated from working during previous or future strikes), and
- the total number of doctors in training (headcount) due to be at work on each strike
- a screenshot of the template can be found in Annex D
SitRep data collections – which organisations should complete the collections?
All NHS Trusts are required to submit data, even if it is a nil return.
ICBs, as employers, are not required to submit a response to the Workforce collection.
Due to the nature of SDCS, some non-NHS organisations such as Community Interest Companies (CICs) may receive requests to complete these Sitreps. Returns from CICs are optional.
SitRep data collections – when will collections run and what dates are in scope?
The rescheduled activity collection will run three times and cover the following periods:
| Period of action | D-3 (activity est.) | D-1 (activity est.) | D+1 (activity impacts and workforce) | Period covered by the collection | |
| Date | Date | Date | Date | Dates | # Days |
| 27 June – 2 July | 24 June | 26 June | 3 July | 25 June – 4 July | 10 |
The workforce collection will run once following the period of industrial action on 3 July.
Highlights of the activity and workforce data collected following industrial action will be published on NHS England’s website in the usual way.
SitRep data collections – guidance for submitters
The window will close at 1pm on the days of collection and will not be reopened.
Submissions will be made through the SDCS platform. On any day that the collection is running we will open the collection at 9.00am and the deadline for submission will be 1.00pm that day. The template will be available to download from SDCS from 9.00am on the first day the collection is running. Missing returns will be highlighted to regional Chief Operating Officers to follow-up.
More detailed guidance notes will be shared with those registered as submitters in SDCS ahead of the first collection. An extract can be found in Annex E.
Thank you for your ongoing cooperation and assistance in providing this information and ensuring a high response rate. We appreciate your dedicated efforts to deliver the highest quality care to NHS patients during industrial action. Should you have any queries, please reach out to your regional team.
Yours sincerely,
Mike Prentice, National Director for NHS Resilience, NHS England.
Annex A: acute rescheduled activity SitRep (screenshot)
Collection period 25 June to 4 July 2024
Annex B: mental Health and Learning Disability rescheduled activity SitRep (screenshot)
Collection period 25 June to 4 July 2024
Annex C: community services rescheduled activity SitRep (screenshot)
Collection period 25 June to 4 July 2024
Annex D: workforce collection (screenshot)
Collection on 3 July 2024
Annex E: extract from guidance for Industrial Action Sitrep collections
Rescheduled activity SitRep
| Column name | Guidance |
|---|---|
| Date | Specify the day that the appointment was originally planned for. |
| 1a. All Inpatient | A count of all standard inpatient (i.e. Not Day case) appointment/ procedure scheduled for the specified date that has been changed by the provider due to industrial action. This includes both appointments where a new date has been provided and those where a new date has not yet been confirmed. |
| 1b. of which P1/P2 cancer surgery | Of all those in 1a, the number that were for P1/P2 surgeries relating to cancer a cancer pathway. |
| 1c. of which P3/P4 cancer surgery | Of all those in 1a, the number that were for P3/P4 surgeries relating to a cancer pathway. |
| 1d. of which cancer colonoscopy | Of all those in 1a, the number that were for colonoscopies relating to cancer a cancer pathway. |
| 1e. of which radiotherapy treatments | Of all those in 1a, the number that were for radiotherapy. |
| 1f. of which chemotherapy treatments | Of all those in 1a, the number that were for chemotherapy. |
| 2a. All Day case | Any Day Case inpatient appointment/ procedure scheduled for the specified date that has been changed by the provider due to industrial action. This includes both appointments where a new date has been provided and those where a new date has not yet been confirmed. |
| 2b. of which cancer surgery | Of all those in 2a, the number that were for surgeries relating to cancer a cancer pathway. |
| 2c. of which cancer colonoscopy | Of all those in 2a, the number that were for colonoscopies relating to cancer a cancer pathway. |
| 2d. of which radiotherapy | Of all those in 2a, the number that were for radiotherapy. |
| 2e. of which chemotherapy | Of all those in 2a, the number that were for chemotherapy. |
| 3a. Total Outpatient appointments | Count of all outpatient appointments/ procedures scheduled for the specified date that has been changed by the provider due to industrial action. This includes both appointments where a new date has been provided and those where a new date has not yet been confirmed. This cell is auto-calculated from the contents of 3b and 3c. |
| 3b. All New (incl 2 week waits) | Of all those in 3a, how many rearranged appointments are New appointments, including those from a 2 week wait referral including triage appointments. |
| 3c. Reviews | Of all those in 3a, how many rearranged appointments are review appointments. |
| 4a. Of 3a, the total Cancer-related outpatients | Count of all cancer related outpatient appointments/ procedures scheduled for the specified date that has been changed by the provider due to industrial action. This includes both appointments where a new date has been provided and those where a new date has not yet been confirmed. |
| 4b. New 2 week waits inc. triage appointments | Of all those in 4a, how many rearranged appointments are New, 2 week wait referral appointments, including triage appointments. |
| 4c. Of which are cancer colonoscopy | Of all those in 4a, how many rearranged appointments are for a colonoscopy appointment relating to a cancer pathway. |
| 4d. Of which are radiotherapy | Of all those in 4a, how many rearranged appointments are for a radiotherapy appointment. |
| 4e. Of which are chemotherapy | Of all those in 4a, how many rearranged appointments are for a chemotherapy appointment. |
Full guidance will be shared with SDCS submitters ahead of collections.