Industrial action 

Industrial action Q&A

Do I have the right to strike?

You are legally entitled to take part in lawful industrial action, including strike action. There is nothing in Good medical practice and its explanatory guidance that prevents you from doing this, providing you continue to follow their principles, which aim to support patient safety.

The only exception to this is if you work as a doctor in the military, where different rules apply. You can find out further information on this from your defence responsible officers.

How can I follow the principles in Good medical practice, when preparing for strike action? 

As medical professionals committed to patient care, we recognise that your decision to strike is a difficult one. We know that you’re motivated not just by duties to your own patients, but also to the wider patient population. You’ll be balancing any potential patient safety risks with a number of other factors in reaching your decision to take action at this time.

Whether you choose to take part in strike action or not, you’ll need to follow the principles in Good medical practice and its explanatory guidance. For example, every doctor will need to consider in advance how the proposed actions will impact continuity of care for existing patients, emergency care, and patient safety, in discussion with your employers and other colleagues. This is in line with the principles in paragraphs one and two of Leadership and management for all doctors.

However, employers have a vital role in planning and preparing for maintaining patient safety during a period of strike action. This includes making sure continuity of care is maintained to the highest possible standard in the circumstances that they face. 

Will I be expected to take on extra work if I’m not taking part in strike action?

You may be faced with challenging situations during strike action, even if you aren’t participating directly. You will need to respond responsibly and reasonably to the situation you face, using your professional judgement to assess any risks and the options available to deliver the best possible care for people in the circumstances. 

Good medical practice says you must offer help if emergencies arise in clinical settings or in the community, taking account of your own safety, competence and the availability of other options for care (paragraph 26). 

You will also need to take prompt action if you think that patient safety is or may be severely compromised (see paragraph 25 of Good medical practice and the guidance on Raising and acting on concerns about patient safety). 

But this doesn’t mean you must take on extra responsibilities or work extra hours. You aren’t obliged to take on an unreasonable workload which may be to the detriment of your performance and patient care, as well as your own health and wellbeing. Employers have a statutory duty to provide safe health services, and legal duties regarding the health and safety of their staff. 

Will the GMC take action, if I make a mistake while working with reduced staffing levels during the strike? 

As is the case for any concerns raised with us, we will consider the individual circumstances and take into account any relevant factors known to us. Such factors include the context you were working in, including wider system or other environmental pressures beyond your control, such as staffing levels. We will also consider any relevant protocols or guidance from your employer in place at the time. This is set out in guidance for fitness to practise decision makers. 

What should I do if there is an emergency situation while strikes are underway?

Good medical practice says you must offer help if emergencies arise in clinical settings or in the community, taking account of your own safety, competence and the availability of other options for care (paragraph 26). 

Whether or not you’re taking strike action, you and your employers will need to consider in advance how to make sure that emergency care can continue to be delivered during any period of strike action, and to keep this under review for the duration of the action. This is in line with the principles in paragraphs one and two of Leadership and management for all doctors.

If a derogation is agreed at my workplace and I’m asked to return to work, what should I do?

It’s not our role to give advice about any legal or contractual issues that may arise in deciding whether to return to work if asked to under a derogation. 

However, our guidance states that doctors must take prompt action if they think that patient safety, dignity, or comfort is being compromised (see paragraph 25 of Good medical practice). They must also work with colleagues in ways that best serve patients’ interests (see Duties of a doctor in Good medical practice) and must offer help if emergencies arise in clinical settings or in the community, taking account of their own safety, their competence and the availability of other options for care (see paragraph 26 of Good medical practice).

During a period of industrial action, where a derogation has been agreed by the union co-ordinating this action, it’s important to follow the derogation to avoid risks to patient safety.

If I’m due to work a shift but will not be attending due to strike action, do I need to remain available?

Whether or not you choose to take strike action, you must continue to follow the principles in Good medical practice.

You must take prompt action if you think that patient safety, dignity or comfort is being compromised (see paragraph 25 of Good medical practice). You must also work with colleagues in ways that best serve patients’ interests (see Duties of a doctor in Good medical practice) and must offer help if emergencies arise in clinical settings or in the community, taking account of their own safety, their competence and the availability of other options for care (see paragraph 26 of Good medical practice).

Circumstances may change during a period of industrial action. If you are due to work, but aren’t attending due to strike action, we advise that you are prepared and remain available during your scheduled working hours to respond appropriately if circumstances change.

Can I leave a shift part way through to take part in strike action?

Paragraph 44 of Good medical practice says that doctors must share relevant information with colleagues when they hand over care as they go off duty and they must check, where practical, that a named clinician or team has taken over responsibility when their role in providing care has come to an end.

The BMA advises its members that if they are already at work when strike action begins, they should finish their shift. 

Postgraduate training 

I’m a trainee in the foundation programme – will going on strike count as time out of training? 

Taking part in a day of industrial action, when you’d normally be at work, would be considered a day of absence from training. But that doesn’t automatically mean that your training progression will be impacted. Trainees have 20 days of permitted absences from training, within each 12 month period, before any review is triggered on whether extra training is required.

Absences from training in the Foundation Programme guidance, for postgraduate deaneries, training boards, foundation schools and medical schools, supports them to implement any review flexibly. This includes taking account of the nature of the absence and whether it has impacted on a doctor’s ability to achieve the desired training outcomes.

This flexible approach was used during the pandemic, when we made clear to training bodies that training progression reviews should be focused on outcomes, and a flexible approach taken to make up any extra training time required. It’s vital that doctors in training get the experiences they need to support their journey to becoming good doctors.

In England, Health Education England also have guidance on managing postgraduate training during periods of industrial action.

What happens if industrial action stops me from meeting my required competencies?

All those involved in supporting postgraduate training need to follow these principles when responding to any disruption of training:

• To holistically assess a doctor’s competency, not quantity of assessments or clinical activity completed.
• To assess whether outcomes are achieved, not the time spent working in a particular area.
• To maintain proportionality and support diversity.
• To make sure patient safety is paramount and sits at the core of education standards. Trainees must not work beyond their competence.
• To maintain standards. Trainees must meet all learning outcomes at the level of performance required for entry to the specialist and GP registers 

These are set out in Excellence by design: standards for postgraduate curricula. In England, Health Education England also have guidance on managing postgraduate training during periods of industrial action.

Medical students

What impact will industrial action have on my learning experiences in medical school? 

We understand that you and your medical schools may be concerned about the impact of industrial action on your learning experiences, and in particular your ability to safely complete clinical placements. 

The response of individual medical schools and placement providers will depend on the local situation.

As set out in Promoting excellence: standards for medical education and training -  medical schools and placement providers must make patient safety their primary concern. They must also make sure that placements are adequately resourced (requirement 1.19 of Promoting excellence). This includes ensuring there are enough suitably qualified members of staff to provide appropriate clinical and educational supervision at all times. Organisations must also make sure learners are not expected to work beyond their competence (requirements 1.8, 1.9 and 1.10 of Promoting excellence). 

Where possible, medical schools should:

• Prioritise clinical placement access, teaching and assessment for later year students, when it is possible for placements to go ahead
• Work with local partners to make appropriate contingency arrangements
• Document any adjustments they make
• Inform medical students about any changes to their clinical placements in a timely fashion.

If you’re worried that a period of industrial action may impact your clinical education, speak to your named clinical supervisor and medical school about these concerns. 

What should I do if I have concerns about my supervision or I’m asked to perform beyond my competency while on placement?

You must be supervised to be safe and act within your competence at all times (requirements 1.8, 1.9 and 1.10 of Promoting excellence). This includes any periods of pressure experienced by the service you are learning in.

You should stop work immediately if, at any time, you’re concerned about your level of supervision, or you’re being expected to work beyond your level of competency.

You should speak to your named clinical supervisor and medical school about these concerns. Medical schools are responsible for making sure medical students have an alternative named clinical supervisor if the planned supervisor is not available.